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Adverse Neurological Events from Immune Checkpoint Inhibitors
Immune checkpoint inhibitors have transformed the natural history of many metastatic cancers and now are widely used. However, the activation of killer T-cells also has caused serious, often fatal complications from the treatment. The central nervous system is a common victim of these complications.
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What Is the Best First-Line Treatment for Young Women with Generalized Epilepsy?
Valproate is a highly efficacious drug for treating idiopathic generalized epilepsy (IGE) but is not an option for many young women because of known teratogenic risks. This retrospective, multicenter study examined women with IGE who were treated initially with either levetiracetam or lamotrigine monotherapy, demonstrating superior efficacy of levetiracetam, although exclusively in women with juvenile myoclonic epilepsy.
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Searching for Step Counts: Defining Goals for Daily Exercise
A systematic review and meta-analysis of studies of the association of step counts and cadence with all-cause mortality and cardiovascular events showed the benefits in these outcomes are statistically significant, at about 2,600 steps/day and peak at about 8,000 steps/day. Also, faster step cadence augments these benefits.
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Can Turmeric Help Handle Heartburn?
In a randomized controlled trial, curcumin demonstrated comparable efficacy to omeprazole in treating dyspepsia and acid reflux.
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Empowered Relief vs. CBT vs. Health Education for Low Back Pain
This randomized clinical trial involving adults with chronic low back pain demonstrates that a single session of a pain management class, when compared to a full course of cognitive behavioral therapy, yields noninferior (clinically on par) outcomes in pain catastrophizing and several other measures at the three-month follow-up.
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The Many Controversies of Cannabidiol
Current trends in cannabinoid research, federal and state cannabis legislation, multi-sourced information, as well as misinformation, all drive consumer interest in cannabidiol (CBD). With the increased use of CBD products, increased incidents of poisonings are being reported. With confusion on policy, on potential benefits and harms, and on long-term chronic effects often seen with excessive use, determining the facts is increasingly problematic for healthcare practitioners and consumers. These issues prioritize the need for clinicians, especially in primary care, to stay current on developments related to CBD and other cannabinoids.
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Vonoprazan Fumarate Tablets (Voquezna)
The U.S. Food and Drug Administration has approved vonoprazan for the treatment of all grades of erosive esophagitis. Vonoprazan is a potassium-competitive acid blocker that originally was approved in 2022 for use in combination with amoxicillin or with amoxicillin and clarithromycin for the treatment of Helicobactor pylori infection.
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Treatable Causes of Rapidly Progressive Dementias
Many cases of rapidly progressive dementia are caused by prion diseases and have no effective treatments. But, with the greater awareness of the presentation for autoimmune encephalitis, these disorders make up an increasing percentage of presenting cases and can be aggressively and successfully treated. The STAM3P score helps to identify potentially treatable cases of this disorder.
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Apixaban Dose in Atrial Fibrillation Patients with Chronic Kidney Disease
A large nationwide health systems database study comparing 5 mg apixaban vs. 2.5 mg twice daily in patients with stage 4/5 chronic kidney disease not on dialysis shows that the 5 mg dose increases the risk of bleeding compared to 2.5 mg without any improvement in the risk of stroke, systemic emboli, or death.
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Slow-Wave Sleep and Risk of Dementia
In this long-term observational study of sleep efficiency in the Framingham Heart Study population, researchers found a strong correlation between a decline in duration of slow-wave sleep during aging and the risk of incident dementia from all causes. However, a direct cause-and-effect relationship cannot be determined from this observational study.