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TAVR Outcomes in Patients on Chronic Corticosteroid Therapy
A 12-year experience with transcatheter aortic valve replacement at one Paris hospital demonstrated chronic systemic corticosteroid use increases the incidence of major 30-day complications and all-cause mortality at one year.
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When Is TAVR Futile?
A study of all patients who underwent transcatheter aortic valve replacement over eight years in France was used to develop a futility score that would help predict who would not live one year after the procedure. This simple clinical score based on comorbidities predicted who would live one year with 95% specificity.
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Ticagrelor in the Elderly: More Potent Platelet Inhibition Not Always Better
In a study of 14,000 elderly patients with acute myocardial infarction, treatment with ticagrelor was associated with higher risks of bleeding and all-cause death vs. clopidogrel.
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Which Acute Myocardial Infarction Patients Need a Blood Transfusion?
A randomized trial of a restrictive blood transfusion strategy vs. a more liberal strategy in patients with acute myocardial infarction and anemia showed the restrictive strategy is noninferior to the liberal strategy for preventing the primary outcome of death, reinfarction, stroke, or emergency revascularization.
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Pralsetinib Capsules (Gavreto)
Pralsetinib should be prescribed to treat adults with metastatic RET, fusion-positive non-small cell lung cancer.
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Pediatric Musculoskeletal Point-of-Care Ultrasound: Everything but the Bones
Ultrasound is an incredible tool that keeps becoming more valuable. In this article, the authors show how point-of-care ultrasound of the musculoskeletal system can help clinicians identify a diversity of diseases, including soft tissue infections, abscesses, and foreign bodies! In a later issue, the authors explore the use of ultrasound to identify bone and joint issues.
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Understanding the Utility of Hemoglobin A1c in Diagnosing Gestational Diabetes in Early Pregnancy
In this retrospective cohort study of 243 pregnant women who had combined hemoglobin A1c (HbA1c) and a two-step oral glucose tolerance testing at less than 21 weeks of gestation, median values of HbA1c were higher in women with gestational diabetes compared to nondiabetics (5.8% compared to 5.3%; P < 0.001). The predictive probability of using HbA1c in diagnosing diabetes in early pregnancy was high compared to two-step testing (area under the curve, 0.8), with an optimal diagnostic threshold of 5.6%. Although a HbA1c level of > 6.5% is diagnostic of early gestational diabetes, a lower diagnostic threshold might be justified during pregnancy.
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Outpatient Foley Catheter for Induction of Labor in Nulliparous Women
In this randomized controlled trial among nulliparous patients with low Bishop scores, outpatient placement of a Foley catheter the day prior to scheduled admission, when compared to inpatient placement, showed a decreased mean time from admission to delivery.
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Maternal Sepsis: Risk Factors that Could Lead to Postpartum Readmission
In this analysis of California deliveries between 2008 and 2011, risk factors for maternal readmission for sepsis were found to include preterm birth, hemorrhage, obesity, and a primary cesarean delivery.
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Prenatal Care Visits During COVID-19
In this nested case-control study in the Boston area, there was no association between testing positive for COVID-19 during pregnancy or on admission to labor and delivery and the number of in-person prenatal care visits.