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LARC Initiative for Teens Leads to 36% Decrease in Pregnancy Rate
A 2016 Kaiser Permanente Northern California initiative improved adolescent access to a long-acting reversible contraceptive through patient education resources, protocols, and insertion training for pediatric, family medicine, and gynecology providers.
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The Degree of Pyuria Can Help Determine Urinary Tract Infection in Elderly Women
Elderly women with a urinary tract infection had a higher median number of urinary leukocytes compared to uninfected controls, including those with asymptomatic bacteriuria. For 264 leukocytes/µL, the sensitivity and specificity of microscopy were 88%. Using the standard pyuria threshold of 10 leukocytes/µL gave a specificity of 36% and a sensitivity of 100%.
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Use of Dexamethasone for Fetal Lung Maturity: A Secondary Analysis of the WHO ACTION-I Trial
The neonatal advantages of prenatal dexamethasone administration seem to increase with longer administration-to-birth intervals than previously believed in women at risk of preterm birth before 34 weeks of gestation.
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The Progestin-Only Pill: How Effective Is It?
In this systematic literature review of 54 studies, the median typical use Pearl Index failure rate was 1.63 (range 0.00 to 14.20) and the median perfect use Pearl Index failure rate was 0.97 (range 0.40 to 6.50).
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Study: Family Planning Services Need Better Integration in Primary Care
There is a growing need for primary care providers to integrate family planning services into their practices, particularly in rural areas and other places where there is no access to OB/GYNs and family planning centers.
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Social Determinants Play Outsized Role in Black/White Cardiovascular Health Gap
Lower income levels, less education, tighter insurance access raise risk for cardiovascular disease mortality.
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Biden Administration Releases 10 Drugs for Price Negotiation
Medications represent 20% of the total Medicare Part D gross covered prescription costs.
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Differentiating MELAS from Bland Ischemic Stroke: Clinicoradiologic Criteria
Stroke symptoms in mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) are difficult to diagnose correctly, which leads to missed opportunities to provide MELAS-specific treatment. Delay in diagnosis also complicates efforts to investigate acute treatments for MELAS. Khasminsky et al proposed clinicoradiologic criteria based on a single-center validation study. Although there are methodological limitations, the concepts highlighted by the authors are valuable.
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Treatment of Preclinical Alzheimer’s Disease
After a four-year, complex clinical trial of an anti-amyloid antibody, solanezumab, there was no benefit in reducing the likelihood of progression of cognitive impairment in patients with positive amyloid positron emission tomography scans who started the trial cognitively unimpaired vs. placebo.
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Super-Refractory Status Epilepticus: Clinical Characteristics, Treatment, and Outcome
Patients with super-refractory status epilepticus (SRSE) differed from patients with first-time status epilepticus in clinical presentations and the treatment course. Although seizure control was achieved in most SRSE patients, the in-hospital mortality and the chance of severe disability at discharge were high.