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Stay up-to-date on topics of Internal Medicine including educational cases, guidelines, important research findings. Admin: Amir Ali Sohrabpour MD Former Provost & Assoc Prof of Gastro/Hepato @ TUMS 🇮🇷 Https://zil.ink/aasohrabpour
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Дописи каналу
| 2 | 4_5861768114290565133.pdf | 180 |
| 3 | Vasopressors or Fluids in Early Septic Shock | 183 |
| 4 | NEJMoa2516225_Vasopressors_or_Fluids_in_Early_Septic_Shock_with.pdf | 182 |
| 5 | 💢 Polycystic ovary syndrome: An update on diagnosis and management
https://www.ccjm.org/content/ccjom/93/3/176.full.pdf
🆔 @InternalMed
. | 491 |
| 6 | 💢 Polymyalgia Rheumatica | 738 |
| 7 |  💢 Dysphagia Lusoria | 526 |
| 8 | https://www.ccjm.org/content/ccjom/93/5/279.full.pdf | 712 |
| 9 | 💢 Management of Nausea
and Vomiting in a Cannabis User
Cannabis can reduce nausea in some disorders (e.g., cyclic vomiting syndrome, gastroparesis) but can also cause recurrent severe vomiting in cannabinoid hyperemesis syndrome (CHS).
CHS is most associated with long-term, frequent, high-dose cannabis use; diagnosis depends on cannabis-use history and improvement after sustained abstinence.
The main treatment is cannabis cessation, though many patients struggle with abstinence because of withdrawal symptoms, perceived benefit from cannabis, and stigma.
For acute CHS episodes, haloperidol and droperidol appear more effective than traditional antiemetics such as ondansetron or metoclopramide.
Other options include topical capsaicin, lorazepam, and aprepitant; IV fluids and electrolyte replacement are important.
Clinicians should avoid assuming that every cannabis user with vomiting has CHS and should use a nonjudgmental, individualized approach. | 938 |
| 10 |  Hypertension is responsible for more than 10 million deaths each year. 5-6 million of those are with 'mild to moderate' hypertension.
We're close to a world where those deaths can be prevented with a shot every six months.
That's what Alnylam is making, and it seems to work! | 721 |
| 11 | 💢 Multiple grey–white plaques on the oropharynx of a 35-year-old man
🆔 @InternalMed
. | 901 |
| 12 | Combined therapy with nebulized and intravenous colistin for the
treatment of multidrug resistance pneumonia in burn patients:
experience from a third referral burn care center in Mexico City | 973 |
| 13 | 42192043_Combined_therapy_with_nebulized_and_intravenous_colistin.pdf | 950 |
| 14 | Answer:
Late-onset systemic lupus erythematosus (SLE).
The patient was treated with intravenous steroids and hydroxychloroquine, resulting in rapid clinical improvement.
The article emphasizes that late-onset SLE (onset after age 50) accounts for 10–20% of lupus cases and often presents with nonspecific symptoms such as fatigue, fever, and weight loss, which may delay diagnosis.
Compared with younger patients, elderly patients are more likely to have serositis, cardiac involvement, thrombosis, and higher mortality, while severe kidney disease is less common.
The main message is that clinicians should consider SLE even in older adults with vague systemic symptoms and oral ulcers to avoid delayed diagnosis and treatment.
🆔 @InternalMed
. | 1 074 |
| 15 |  Question:
A 73-year-old woman presents with painful oral ulcers, fever, weight loss, rash, chest pain, and polyarthritis. Laboratory tests reveal positive ANA and anti-dsDNA antibodies with low complement levels. Imaging shows pleural and pericardial effusions. What is the most likely diagnosis?
🆔 @InternalMed
.
👇 | 895 |
| 16 | https://www.medscape.com/viewarticle/cooling-vest-may-reduce-body-fat-obesity-2026a1000h29?src=rss | 1 013 |
| 17 | NEJMra2415426.pdf | 1 301 |
| 18 | https://podcasts.apple.com/us/podcast/jama-clinical-reviews/id1027430378?i=1000768757830
🆔 @InternalMed
. | 1 366 |
| 19 | Eli Lilly just released Phase 3 data for retatrutide, their next-generation obesity drug. 2,339 patients. 80 weeks. The biggest trial in the field.
8 things worth knowing:
1️⃣ It beats every obesity drug on the market. Wegovy (semaglutide): 15% Zepbound (tirzepatide): 22% Retatrutide: 25%
2️⃣ You don’t need the highest dose. The lowest (4mg) already outperforms Wegovy. 18% weight loss with one dose increase. Fewer people quit than on the sugar pill.
3️⃣ At two years, weight was still dropping. No plateau. Patients with BMI over 35 lost 84 pounds. 30% of their body weight.
4️⃣ Some patients stopped taking it because they lost too much weight. That’s never happened with an obesity drug.
5️⃣ It works differently. Ozempic and Zepbound suppress appetite. Retatrutide does that too, but its third receptor (glucagon) flips your metabolism toward burning stored fat. In Phase 2, ketone bodies rose 2-3x, confirming the body was switching fuel sources.
6️⃣ It causes a side effect no other obesity drug does: tingling and numbness (12.5%). New receptor, new trade-off. Worth watching.
7️⃣ In a separate study, it cleared 86% of liver fat. 93% of patients reached normal levels. 1 in 3 adults have fatty liver disease. No approved drug comes close.
8️⃣ Two-thirds of patients on the highest dose were reclassified out of obesity entirely. They started at BMI 40. They finished under 30. That’s not just weight loss. That’s a medical reclassification.
US FDA filing expected late 2026. | 3 482 |
| 20 |  Supplementation with Vitamin D or calcium, or both does not help prevent fractures or falls. From a new systematic review of 69 randomized trials and >150,000 participants. | 935 |
