Clinical
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Should All Pregnant Women Be Screened for Hepatitis C?
In this cost-effectiveness analysis using Markov modeling, investigators found that universal antenatal screening for hepatitis C was cost-effective, with a mean incremental cost-effectiveness ratio of approximately $3,000 per quality-adjusted life years gained compared to risk-based screening.
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Staged Preeclampsia Screening in Early Pregnancy
The use of 150 mg of daily aspirin from 11 to 14 weeks through 36 weeks of gestation reduces the rate of early preeclampsia (PE) in approximately 90% of at-risk pregnancies. In addition, aspirin also provides the benefit of reducing the risk of PE < 37 weeks by about 60% and the length of NICU stay by about 70%, primarily by reducing the number of neonates delivered before 32 weeks. What constitutes a high-risk patient and what quantifies patient-specific risks before PE develops remain to be answered.
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The Changing Face of Labor Management
Throught the years, clinicians' understanding of the conduct of labor has undergone periodic re-evaluation. In the 1950s, cesarean delivery was a major operation. Today, the procedures are shorter, accompanied by less surgical fanfare, and associated with fewer days in the hospital. Nevertheless, as the only other option to vaginal delivery, the operation, performed in 35% of cases for failure to progress, still should be considered “major” considering its potential for maternal complications.
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Is There AV Block?
The long lead II rhythm strip in the figure was recorded at the standard 25 mm/second speed. This tracing was obtained from a middle-aged woman who presented to an outpatient clinic with noncardiac chest pain. How would one interpret this rhythm? Are there signs of AV block? Is it apparent if there is a cardiac problem?
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Esketamine Nasal Spray (Spravato) CIII
Esketamine, in conjunction with an oral antidepressant, is indicated for the amelioration of treatment-resistant depression in adults.
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Witness Observations in Diagnosing Transient Loss of Consciousness
Investigators found that adding witness-reported observations to patient demographics and patient-reported symptoms improved the diagnostic accuracy between epilepsy, syncope, and psychogenic nonepileptic seizures.
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Medication First? Ablation First? Either Way, Make Weight Loss a Priority
Weight loss management and aggressive risk factor modification associated with slowing or even reversal of atrial fibrillation progression.
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Behavioral Interventions in Adults for Weight Loss or Weight Loss Maintenance
The U.S. Preventive Services Task Force evaluated the risks and benefits of interventions for weight loss and weight loss maintenance to prevent complications from obesity. Panelists found a moderate net benefit from weight loss-intensive behavioral interventions.
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Report Details Effect of Mifepristone Labeling Change
New research indicates that for Texas providers and patients, the 2016 Food and Drug Administration’s (FDA) new labeling for the abortion drug mifepristone increased access options and brought the proportion of medication abortions in the state into alignment with national data.
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Test in Development to Detect Preterm Birth
Scientists at Brigham and Women’s Hospital have published early results of an investigative blood test designed to predict which women may be at increased risk and which ones may be at lower-than-average risk for spontaneous preterm delivery. The researchers have identified circulating microparticle proteins found in blood samples taken in the first trimester of pregnancy that may provide clues about the risk of spontaneous preterm birth.