Role of Metoprolol Succinate in the Treatment of Heart Failure and Atrial Fibrillation: A Systematic Review Background: Beta-blockers are one of the most important classes of cardiovascular agents and have been considered a cornerstone therapy in heart diseases, such as heart failure (HF) and atrial fibrillation (AF). Among different beta-blockers, metoprolol is a selective beta1-adrenergic antagonist, which has been extensively used since the 1970s. Areas of Uncertainty: Although current guidelines include recommendations for the use of controlled-release metoprolol succinate in specific HF and AF indications, and despite extensive clinical experience with metoprolol, comparative evidence on the use of metoprolol succinate compared with other beta-blockers in these indications is limited. Data Sources: We systematically reviewed the data from head-to-head studies directly comparing this compound with other beta-blockers in the treatment of HF or AF. Only clinical trials and observational studies were considered; no other limits were applied. The quality and relevance of retrieved articles were reviewed. Results: A total of 18 articles of the 353 articles identified were selected for inclusion; 12 HF articles and 6 for AF. Additional references were identified from the bibliographies of retrieved articles. The studies show that oral prophylaxis with an appropriate dose of metoprolol may reduce new incidents of AF in high-risk patients. Furthermore, metoprolol succinate is associated with significant mortality and morbidity benefits in the treatment of HF. Conclusions: Despite the introduction of newer beta-blockers with differing clinical characteristics since its introduction, metoprolol succinate remains a useful drug in both HF and AF. Address for correspondence: Dragos Vinereanu, MD, PhD, FESC, FRCP, Department of Cardiology, University of Medicine and Pharmacy Carol Davila and University and Emergency Hospital, Splaiul Independentei 169 St, Bucharest 050098, Romania. E-mail: vinereanu@gmail.com Medical writing assistance for the development of this manuscript was funded by Recordati. D. Vinereanu reports research grants and personal fees from Recordati, Menarini, Astra-Zeneca, Merck, Pfizer, BMS, Novartis, Servier, and Terapia. A. Pathak reports grants and personal fees from Recordati. D. Kozlowski reports grants and personal fees from Sandoz, Pfizer, Astra-Zeneca, Recordati, and Berlin-Chemie. The remaining author has no conflict of interest to disclose. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Acetazolamide-Associated Idiosyncratic Simultaneous Bilateral Angle Closure and Cross-Sensitivity No abstract available

Acute Silver Toxicity From Colloidal Silver Overdose No abstract available

Deprescription of Antihypertensive Medication in Aging: A Debatable Issue No abstract available

Rituximab to Treat Fibrosing Mediastinitis–Associated Recurrent Hemoptysis No abstract available

Vancomycin-Associated Erythema Multiforme No abstract available

Topical Administration of Amphotericin B as an Effective Adjuvant Treatment for a Deep Fungal Infection of Diabetic Foot Injury No abstract available

Prevalence of Colorectal Neoplasms and Mortality in New Users of Low-Dose Aspirin With Lower Gastrointestinal Bleeding Background: Aspirin inhibits platelet function and may therefore accelerate early lower gastrointestinal bleeding (LGIB) from colorectal cancer (CRC) precursor polyps. The bleeding may increase endoscopic polyp detection. Study Question: To estimate the prevalence of polyps and CRC comparing new users of low-dose aspirin with nonusers who all received a diagnosis of LGIB and to investigate the mortality among these patients. Study Design: Using Danish nationwide health registries, we conducted a cohort study (2006–2013) of all new aspirin users who also received a diagnosis of LGIB (n = 40,578). Each new user was matched with 5 nonusers with LGIB by gender and age at the LGIB diagnosis date. Measures and Outcomes: We computed the prevalence and prevalence ratios (PRs) of colorectal polyps and CRCs, and the mortality ratios within 6 months after the LGIB, comparing new users with nonusers. Results: We identified 1038 new aspirin users and 5190 nonusers with LGIB. We observed 220 new users and 950 nonusers recorded with endoscopically detected polyps. New aspirin users had a higher prevalence of conventional {PR = 1.28 [95% confidence interval (CI): 1.06–1.55]} and serrated [PR = 1.31 (95% CI: 0.95–1.80)] polyps. New users and nonusers had a similar prevalence of CRC [PR = 1.04 (95% CI: 0.77–1.39)]. However, after stratifying by location of CRC, the prevalence of proximal tumors was lower [PR = 0.71 (95% CI: 0.35–1.43)] in new users than in nonusers. No difference in mortality was observed. Conclusions: These findings indicate that new use of low-dose aspirin is associated with an increased detection of colorectal polyps compared with nonuse. Address for correspondence: Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus 8200, Denmark. E-mail: frtroe@clin.au.dk The Department of Clinical Epidemiology, Aarhus University Hospital, receives funding for other studies from companies in the form of research grants to (and administered by) the University of Aarhus. None of these studies have relation to the present paper. The authors have no conflicts of interest to declare. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.americantherapeutics.com). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Imatinib-Associated Pneumocystis jirovecii Pneumonia in a Patient With Chronic Myeloid Leukemia No abstract available

Quetiapine-Associated Pseudotumor Cerebri No abstract available