The American journal of medicine
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For decades, omega-3 fatty acids (O3FA) have been used for their cardioprotective effects. Although several prescription products are available, icosapent ethyl (IPE) is the lone pure, eicosapentaenoic acid (EPA)-only, O3FA product. ⋯ Based on the REDUCE-IT trial, the Food and Drug Administration granted IPE an indication for ASCVD risk reduction, making it the first O3FA product to receive such an indication. IPE is a cost-effective approach to reducing residual cardiovascular risk in high risk patients treated with statins.
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Multiple sclerosis (MS) is a common, severe neurological disease that affects millions of people worldwide. Nevertheless, the actual cause of MS remains unknown. Smoking has been studied with respect to MS development and progression. ⋯ Furthermore, smoking has been linked to the progression of MS at the patient and population levels. However, the underlying mechanism remains to be explored in further studies; researchers still disagree on how the relationship between smoking and MS arises in different populations. Evidence from randomized controlled trials, systematic reviews, and epidemiological studies shows that smokers have a higher risk of developing MS and experiencing related adverse symptoms and complications.
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Migraine is the third-most prevalent disease in the world and affects approximately 39 million individuals in the United States alone. Migraine occurs in nearly 1 in 7 individuals between 15 and 49 years of age and is 3 times more frequent in women than in men. The Food and Drug Administration (FDA) recently approved 3 new humanized monoclonal antibodies that target calcitonin gene-related peptide (CGRP): erenumab, fremanezumab, and galcanezumab. ⋯ All 3 products are indicated for preventative treatment of episodic or chronic migraine in adults. The available studies to date document that these agents reduce migraine attacks. The CGRP monoclonal antibodies offer patients new options once they have exhausted other treatments.
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Aspergillus spp. is a ubiquitous mold found commonly in our environment that can cause a spectrum of pulmonary disorders, ranging from a hypersensitivity reaction to an acutely invasive disease with significant mortality. Allergic bronchopulmonary aspergillosis results from airway hypersensitivity from aspergillus colonization almost exclusively in patients with asthma and cystic fibrosis. Chronic pulmonary aspergillosis typically presents in immunocompetent patients with underlying lung pathology. ⋯ There are more effective and better-tolerated antifungal agents that have improved patient outcomes. This review introduces the spectrum of pulmonary aspergillosis geared toward generalists, including disease manifestations, most recent diagnostic criteria, and first-line treatment options. Involving a multidisciplinary team is vital to the early diagnosis and management of these diseases.
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Meta Analysis
Postponement of Death by Pharmacological Heart Failure Treatment: A Meta-Analysis of Randomized Clinical Trials.
Outcome postponement has been proposed as an effect measure for preventive drug treatment. It describes the average delay of the investigated unwanted clinical event, achieved by taking medication. The objective was to estimate postponement of death for the following heart failure medications compared to placebo: beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), ARB added to ACE inhibitors, aldosterone antagonists, ivabradine, and renin antagonists. ⋯ The modeled outcome postponement estimates reiterate beta-blockers, ACE inhibitors, and aldosterone antagonists as the mainstay of heart failure treatment. Furthermore, ivabradine or ARBs added to ACE inhibitors results in no statistically significant gain in survival.