Clinical
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Antidepressants for Chronic Pain: Do They Work?
Antidepressant medications have been widely used for treating a variety of chronic pain disorders but strong evidence to support their efficacy is lacking. Some patients may respond, but available data do not help us to determine which agents may be helpful in a specific type of chronic pain condition.
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Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?
A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.
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Brain Atrophy and Type 1 Diabetes
In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.
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Angiographic Fractional Flow Reserve Is Useful, But Not Ready for Prime Time
Using a blinded, independent core laboratory, researchers compared five commercially available angiographic fractional flow reserve (FFR) methods to the pressure wire-based FFR technique. The authors found the diagnostic accuracy of these software techniques surpassed that of two-dimensional quantitative coronary angiography, but fell short of what has been reported in validation trials run by individual vendors.
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The Value of the GRACE Risk Score for Triaging Non-ST-Elevation Acute Coronary Syndrome Patients
A prospective, pragmatic, cluster, randomized clinical study of using the Global Registry of Acute Coronary Events (GRACE) risk score and standard care for the management of non-ST-elevation acute coronary syndromes failed to demonstrate more use of guideline-recommended care or better outcomes.
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Alcohol: Double-Edged Sword, or Hatchet?
Researchers reported consuming two to 14 alcoholic drinks per week was associated with fewer major adverse cardiovascular events, which the authors noted could be explained in part by less stress-related neural activity demonstrated on PET and CT scans.
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Can Physical Activity Thwart the Negative Cardiometabolic Effects of Obesity?
Compared to normal-weight workers, overweight or obese employees in Spain exhibited a higher prevalence of risk factors for cardiovascular disease, which can be partially mitigated by regular exercise.
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Reconsidering Aspirin Therapy for Elderly Patients
A post-hoc analysis of the ASPREE trial revealed that in presumably healthy elderly subjects, taking low-dose aspirin daily over three years was associated with a significant drop in hemoglobin and ferritin levels vs. placebo, even when patients with major bleeding events were excluded.
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Diagnosing and Treating Pelvic Inflammatory Disease
The term pelvic inflammatory disease (PID) describes a compilation of infections that arise from an ascending infection of the vagina or cervix to the upper genital tract, which is comprised of the uterus, fallopian tubes, and ovaries. These infections include, either alone or in combination, tubo-ovarian abscess, salpingitis, endometritis, and peritonitis. Making the diagnosis of PID is important, since it is associated with uterine and fallopian tube scarring leading to tubal factor infertility and ectopic pregnancy, as well as chronic pelvic pain. This article provides an evidence-based review of diagnostic and treatment recommendations for PID.
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Artificial Intelligence Might Help Clinicians Answer Patient Questions
Researchers evaluated the ability of ChatGPT to answer patient questions posed in an online forum. The authors found the chatbot generated quality and empathetic answers. These results suggest artificial intelligence assistants might help draft responses to patient questions.