Table of Contents
From the Editor
- It’s a new year, looking back and looking forward
Reflections on highlights from 2023 and impending changes in 2024, along with some acknowledgments and farewells.
The Clinical Picture
- Conjunctival petechiae in infective endocarditis
A 75-year-old-man presented with a 33-day history of intermittent nocturnal fevers of 39°C (102°F) and truncal rashes. The rashes appeared on the same day as the fever.
Review
- Consumer-grade wearable cardiac monitors: What they do well, and what needs work
The authors review common consumer-grade wearables, including the accuracy of these monitors compared with medical-grade devices, and present an approach to managing rate or rhythm abnormalities identified on at-home monitoring.
Editorial
- Wearable cardiac monitors: Where do we stand?
Wearable monitors perform well as screening tools for atrial fibrillation, but questions remain: Can they help with stroke prevention, what is their role in patients with known atrial fibrillation, and how do we streamline interpretation?
Review
- Gastric intestinal metaplasia and gastric cancer prevention: Watchful waiting
Malignancy develops in only a small minority of patients with gastric intestinal metaplasia. Recognition of clinical, endoscopic, and histologic features linked with cancer development is critical to identifying patients who require endoscopic surveillance.
- 2023 Update in ambulatory general internal medicine
Topics reviewed include prevention of chronic kidney disease progression, diet for preventing secondary cardiovascular disease, prevention of kidney-stone recurrence, drug therapy for weight loss, and cholesterol management.
1-Minute Consult
- When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure?
Evidence from clinical trials supports starting these medications as early as possible in patients hospitalized with acute decompensated heart failure who do not have clear contraindications to them.
Current Drug Therapy
- Nonstatin therapy to reduce low-density lipoprotein cholesterol and improve cardiovascular outcomes
Several new nonstatin medications have been approved in recent years, with robust data from clinical trials supporting their use in atherosclerotic disease.