Clinical
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Evaluation of an Inpatient Postpartum Human Papillomavirus Immunization Program
In this cohort study, results from two years of an inpatient postpartum HPV vaccination program are presented. Overall, their results show an increased rate of immunization (hazard ratio of 2.51) and an increased proportion of women completing the vaccination series (35.8% of those receiving an inpatient dose completed the series compared to 9.3% of those who did not get the inpatient dose).
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When Is the Ideal Time in the Menstrual Cycle for IUD Insertion?
In this retrospective cohort study, women using the levonorgestrel intrauterine device for noncontraceptive indications had higher expulsion rates (38% vs. 17%, P = 0.03) when insertion occurred on day 1 to day 8 of the menstrual cycle compared to after day 8.
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The Association Between SSRIs and Congenital Anomalies
In this synthesis involving 15 meta-analytic studies, four studies demonstrated an association between paroxetine use during pregnancy and increased risk of major congenital anomalies (relative risk [RR], 1.18 [95% confidence interval (CI), 1.05, 1.32] to 1.29 [95% CI, 1.11-1.49]). For all selective serotonin reuptake inhibitors (SSRIs), the RR for major anomalies (1.10 [95% CI, 1.03, 1.16] to 1.27 [95% CI, 1.09, 1.47]) and cardiac defects (1.06 [95% CI, 0.94, 1.18] to 1.36 [95% CI, 0.61, 3.04]) were increased. This meta-analysis suggests an increased risk of cardiac and major anomalies with SSRI use, but the results should be interpreted with caution, since all included studies were meta-analyses of retrospective cohort studies.
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Management of Heavy Menstrual Bleeding: Levonorgestrel-Releasing Intrauterine System vs. Endometrial Ablation
In this multicenter, randomized, noninferiority trial among patients aged 34 years and older with heavy menstrual bleeding, the levonorgestrel-releasing intrauterine system did not meet the noninferiority threshold when compared to endometrial ablation for mean blood loss at 24 months following intervention. Both interventions did lead to large decreases in blood loss and comparable satisfaction and quality-of-life scores.
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Pegcetacoplan Injection (Empaveli)
The FDA has approved a new treatment for paroxysmal nocturnal hemoglobinuria, a rare, life-threatening blood disease. -
Stroke and Risk of Suicide
Stroke should be considered a risk factor for suicide. Tactics to screen and treat depression and suicidal ideation should be an important component of long-term follow-up and care for stroke patients. -
Ischemic Stroke in Patients with COVID-19
Since the first cases of COVID-19 were reported in the United States, severe ischemic strokes also have been reported in some of these patients, some with large vessel occlusions and case reports of thrombectomy for treatment. -
Rapid Intermittent Bolus of Hypertonic Saline May Be Better Way to Correct Symptomatic Hyponatremia
Hypertonic saline given via rapid intermittent bolus therapy was as effective and safe as slow continuous infusion, and was associated with a lower rate of recorrecting treatment and higher efficacy in achieving goal sodium within one hour. -
The Danger of ADHD Overdiagnosis
A growing concern about overdiagnosis of attention-deficit/hyperactivity disorder in adolescents and children demonstrates a need for a decisive answer to this concern. -
Another Agent for Hypercholesterolemia
A pooled analysis of three trials of inclisiran in patients with atherosclerotic cardiovascular disease or its risk equivalent showed impressive reductions in LDL cholesterol with subcutaneous injections.