Clinical
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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.
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Exploring the Mixed Messages of Research Regarding Alcohol
The authors of a large systematic review and meta-analysis concluded there is no health benefit from moderate alcohol intake.
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Can Antidepressants Help Patients Manage Chronic Pain?
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 determine which agents may be helpful in a specific type of chronic pain condition.
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Oils, Fats, and Mortality: Examining Fats’ Effects on Health and Longevity
This comprehensive prospective study reveals that, compared to non-consumers, individuals using butter and/or margarine have an elevated total mortality rate, while those incorporating canola and/or olive oil into their diets exhibit a reduced total mortality risk.
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What Are F-Waves and What Do They Tell Us?
The presence or absence of F-waves is an important observation during the electrophysiological investigation of a patient with acute, progressive weakness. But the underlying physiological basis of F-waves has been elusive. This ex vivo animal study showed that F-waves are solely generated by motor nerves arising from the ventral horn of the spinal cord and require intact synapses.
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Safety and Efficacy of Mogalizumab in HTLV-1-Associated Myelopathy
Human T-cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis develops in a small number of carriers of this retrovirus as the result of infection and suppression of CD4+ T-cells. Therapy with steroids has been the mainstay but is not safe or effective for the long term. Mogalizumab shows promise as long-term therapy of this debilitating disease.
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Gut Microbiome Metabolites and Progression of Parkinson’s Disease
A Mendelian randomization study shows that trimethylamine N-oxide and its precursor metabolites are not associated with risk of Parkinson’s disease (PD) but have both positive and negative causal effects on some indicators of PD severity and progression.
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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.