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Malaria in Pregnancy — Simplified Treatment Decisions
History, data, and international consensus lead to the same conclusion: Artemether-lumefantrine is the first choice for treatment of uncomplicated falciparum malaria in everyone, even pregnant women.
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Variables Associated with Resolution and Persistence of Ovarian Cysts
This prospective cohort study evaluated 2,683 individuals with incidental cysts discovered during ovarian cancer screenings to determine what factors are associated with cyst resolution over time. Characteristics such as smaller cysts, septated cysts, younger age, premenopausal status, and family history of ovarian cancer were associated with an increased percentage of cyst resolution overall, and factors including older age and lack of hormone therapy were associated with a faster rate of cyst resolution over time. The findings of this study indicate that different surveillance times may be appropriate, depending on cyst morphology and patient characteristics.
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Metformin for the Management of Early Gestational Diabetes
The administration of metformin in the early stages of gestational diabetes did not demonstrate superiority over placebo in relation to the need to start insulin therapy prior to delivery, or on fasting blood glucose concentrations ≥ 5.1 mmol/L at either the 32nd or 38th weeks of gestation (composite primary outcome).
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Oral Contraception and Obesity
This study was a re-analysis of drospirenone 4 mg Phase III efficacy trials comparing 590 non-obese and 325 obese patients who showed equivalent pregnancy rates with Pearl Indices of 3.0 (95% confidence interval [CI], 1.3 to 5.8) and 2.9 (95% CI, 0.8 to 7.3), respectively.
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To Activate the Cath Lab?
The ECG in the figure was recorded on a patient with new chest pain that began one hour earlier. How would you interpret this ECG? Should the catheterization lab be activated, given the history and this ECG?
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Tirzepatide Injection (Zepbound)
The U.S. Food and Drug Administration has approved tirzepatide for chronic weight management. The drug previously was approved for the treatment of type 2 diabetes under the trade name Mounjaro.
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Time of Day Affects the Probability of Antibiotic Initiation for Hospitalized Patients with Sepsis
In this retrospective cohort study of patients with hospital-onset sepsis, the probability of antibiotic initiation was lowest at shift changes and gradually declined overnight compared to during the day shift.
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Antibiotic Stewardship vs. Diagnostic Stewardship for Reducing Unnecessary Antibiotics in Asymptomatic Bacteriuria
A statewide quality study compared antibiotic stewardship to diagnostic stewardship for hospitalized patients with asymptomatic bacteriuria. It found that reducing urine cultures decreased unnecessary antibiotic prescribing better than antibiotic stewardship.
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The Natural History of Aortic Stenosis Revisited
A large multi-institution observational study of patients referred for Doppler echocardiography to assess for aortic stenosis has shown that discrepant measurements are not uncommon. When four-year all-cause untreated mortality is considered, the intermediate grades of aortic stenosis behave like the next highest level stenosis, which suggests that we should consider intervening earlier in moderate to severe stenosis.
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Aerobic Exercise Effective for Erectile Dysfunction
Exercising for 30 minutes or more three times a week is effective for improving erectile function.