Articles Tagged With:
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Are Women with Atrial Fibrillation Still at Higher Risk of Ischemic Stroke?
A Finnish national database study of newly diagnosed atrial fibrillation from 2007-2018 has shown that the independent association of ischemic stroke risk with female sex initially was high but trended downward to nonsignificant at the end of the study. This has implications for the risk stratification of atrial fibrillation patients regarding oral anticoagulation therapy.
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Insights from the Apixaban vs. Aspirin for Subclinical Atrial Fibrillation Trial
An analysis of the ARTESiA trial of apixaban vs. aspirin for stroke prevention in subclinical atrial fibrillation by CHA2DS2VASc score has shown that the benefits of apixaban outweigh the risk of major bleeding at scores > 4 and the opposite is true at scores < 4.
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Empagliflozin Post-Acute Myocardial Infarction
A prespecified further analysis of the EMPACT-MI trial has shown that patients within two weeks of an acute myocardial infarction who are at risk for heart failure who receive empagliflozin compared to placebo have significantly fewer episodes of heart failure hospitalizations over a median follow-up of 18 months.
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Impella Scores a Big Win in Infarct-Related Cardiogenic Shock, but with Big Caveats
In this randomized controlled trial of patients presenting with ST-elevation myocardial infarction and cardiogenic shock, use of the Impella microaxial flow pump resulted in improved survival but also higher adverse safety events compared with standard care.
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Furosemide for the Management of Postpartum Hypertension
Current evidence does not support the effectiveness of furosemide in reducing the mean arterial pressure within 24 hours before discharge from delivery hospitalization or before starting antihypertensive medications, compared to a placebo.
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What Do Clinicians Think About the American Cancer Society Cervical Cancer Screening Guidelines?
In this study of provider attitudes toward the American Cancer Society 2020 cervical cancer screening guidelines that recommend deferring screening until age 25 years and using human papilloma virus alone as the primary screening, most providers had not adopted the guidelines and were waiting for endorsement by other professional societies, such as the American College of Obstetricians and Gynecologists and the American Society for Colposcopy and Cervical Pathology.
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Targeting Vasomotor Symptoms with a Neurokinin-3 Receptor Antagonist
A meta-analysis of five randomized controlled studies showed that fezolinetant improved moderate-to-severe vasomotor symptoms with a pooled mean difference of 2.62 episodes per day (95% confidence interval [CI], 1.85-3.41) and had no significant adverse effects compared to placebo (odds ratio, 1.01; 95% CI, 0.84-1.22).
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Safety of Non-Insulin Antidiabetic Medications in Early Pregnancy
A multinational cohort study of more than 50,000 pregnant people found that those with periconceptual use of non-insulin antidiabetic medications, such as sulfonylureas, dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 agonists, or sodium-glucose cotransporter 2 inhibitors, did not have increased risk of congenital malformations compared to those who used insulin periconceptually.
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Scarlet Fever and Invasive Streptococcal Disease
While most physicians are familiar with the common presentations of streptococcal infections (e.g., pharyngitis, impetigo), it is important to recognize the carrier state, learn management of common complications (e.g., peritonsillar abscess), and identify the potentially serious, and perhaps deadly, complications and invasive infections.
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A Run of Aberrant AFib?
The patient whose electrocardiogram (ECG) appears in the figure is a previously healthy man who presented to the emergency department because of acute dyspnea. What is the cause of the run of wide beats?