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Internal Medicine
Journal Scan

Journal Brief: Top 5 Internal Medicine Articles

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Is patent foramen ovale closure superior to oral anticoagulants therapy in patients with cryptogenic stroke?

Recent randomized controlled trials have shown the benefits of patent foramen ovale device closure in the prevention of stroke recurrence in patients with patent foramen ovale compared with medical therapy alone. The researchers concluded that it is not known if PFO closure is superior to oral anticoagulants therapy in these patients.

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Reference
Fukutomi M, Wilkins  B, Søndergaard L. The role of device closure of patent foramen ovale in patients with cryptogenic stroke. J Intern Med. 2020; https://doi.org/10.1111/joim.13143

Multilevel upper airway surgery beneficial in patients with obstructive sleep apnea

Combined palatal and tongue surgery improved sleepiness at 6 months in adult patients with moderate or severe obstructive sleep apnea who did not improve with conventional treatment, according to results of a randomized clinical trial of 102 adults. According to the study authors, additional research is needed to confirm these findings.

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Reference
MacKay S, Carney AS, Catcheside PG, et al. Effect of multilevel upper airway surgery vs medical management on the Apnea-Hypopnea Index and patient-reported daytime sleepiness among patients with moderate or severe bbstructive sleep apnea: The SAMS randomized clinical trial. JAMA. 2020. doi:10.1001/jama.2020.14265

Flu vaccine in pregnancy not linked to increased risk for autism

Due to concerns that the flu vaccine during pregnancy may be linked to an increased risk for autism spectrum disorder, researchers population-based cohort study analyzed mothers who were vaccinated against A(H1N1)pdm09 during pregnancy. The researchers found no association between receiving the H1N1 vaccination during pregnancy and a risk for autism spectrum disorder in children.

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Reference
Ludvigsson JF, Winell H, Sandin S, et al. Maternal influenza A(H1N1) immunization during pregnancy and risk for autism spectrum disorder in offspring. Ann Intern Med. 2020; https://doi.org/10.7326/M20-0167.

High-intensity treatment program for obesity in underserved populations led to weight loss
In an underserved primary care population, a high-intensity, lifestyle-based treatment program for obesity, which focused on reducing the number of calories eaten and increasing exercise, led to a clinically significant loss of weight at 2 years.

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Reference
Katzmarzyk PT, Martin CK, NewtonRL, et al. Weight loss in underserved patients — A cluster-randomized trial. N Engl J Med. 2020;383:909-918. DOI: 10.1056/NEJMoa2007448

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