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  • Adverse Outcome Predictors in Pregnancies Complicated by SLE

    A prior history of lupus nephritis, active systemic lupus erythematosus (SLE) at conception, secondary antiphospholipid syndrome, and chronic hypertension are critical predictors of adverse pregnancy outcomes in women with SLE.

  • Twelve-Month Contraceptive Prescriptions: Do They Make a Difference?

    In this national retrospective cohort study of patients on Medicaid, states with 12-month hormonal contraceptive supply policies increased their 12-month dispensing by only 4.39% compared to the pre-policy period. The majority of this increase was contributed by the state of California.

  • Individualizing Opioid Prescriptions After Cesarean Delivery

    A multicenter, randomized controlled trial of 5,521 participants who underwent uncomplicated cesarean deliveries found that an individualized opioid prescription protocol (IOPP) with shared decision-making was noninferior to a fixed prescription regarding the proportion of participants experiencing moderate to severe pain one week post-discharge, while significantly reducing the number of opioid tablets prescribed at discharge (median of 14 tablets vs. 20 tablets, P < 0.001).

  • Does the Physical Exam Help?

    You are given the electrocardiogram (ECG) in the figure and told that the patient is a young man in his 20s who presents with acute dyspnea. The physical exam is remarkable for tachypnea, cyanosis, and clubbing of the extremities. How would you interpret the rhythm? Do the noted physical exam findings help in your assessment of the rhythm?

  • Sulopenem Etzadroxil and Probenecid (Orlynvah)

    The U.S. Food and Drug Administration has approved a combination of sulopenem and probenecid for the treatment of uncomplicated urinary tract infections.

  • Epilepsy and Cardiovascular Events

    This large prospective cohort study found that older adults with a lifetime history of epilepsy were more likely to experience cardiovascular events (CVEs), and that enzyme-inducing antiseizure medications (EIASMs) may account for a significant portion of this risk. The findings suggest a potential causal link between epilepsy treated with EIASMs and CVE, highlighting the need for careful medication selection in epilepsy management.

  • Comparison of Postoperative Antibiotic Regimens for Complex Appendicitis

    In a pragmatic, open-label, randomized trial conducted at 15 hospitals in the Netherlands, two days of postoperative intravenous antibiotics for complex appendicitis was found to be noninferior to five days in terms of infectious complications and mortality within 90 days.

  • DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke

    In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), resulted in no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.

  • Migraines: Which Came First, the Chocolate or the Craving?

    Knowledge of the differentiation between the triggers for a potential migraine attack and the prodromal symptoms of an initiated migraine attack reveals strategies that decrease migraine disability. Recognition of migraine triggers allows for a modification of behavior to avoid precipitating an attack. Recognition of common migraine prodromal symptoms creates an early time window when rapid treatment enhances the therapeutic intervention’s efficacy.

  • Osteoporosis: An Update for Primary Care Providers

    Bones, as reservoirs of calcium and phosphorus, continuously remodel to maintain strength and function. However, suboptimal peak bone mass in young adulthood, excessive resorption of bone, or impaired bone formation during remodeling can result in osteoporosis. Among Caucasian adults ages 50 years and older in the United States, about 50% of women and 20% of men will experience an osteoporotic fracture in their remaining lifetime; however, fracture rates differ by ethnic/racial population and skeletal site. Annual fracture-related costs are expected to increase from $57 billion to more than $95 billion by 2040. Therefore, it is imperative that primary care providers address this challenge by implementing practices to screen patients for osteoporosis to prevent and/or treat the disorder and subsequent comorbidities.