Clinical
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Clinical Briefs
In this section: Some good news for type 2 diabetes patients; hormone replacement during menopause; and chasing an unusual rosacea lead.
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Functional Outcomes After Receiving Life-sustaining Therapy in the ICU
Among patients who have spent at least three days in an ICU and required even brief mechanical ventilation and/or vasopressor support, almost half are dead and only one-third return to their baseline at six months. Several factors present on the first day of admission are associated with not returning to baseline status.
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Irritable Bowel Syndrome, Constipation, and Quality of Life in Women
Irritable bowel syndrome has a negative effect on women’s quality of life and affects one-third of women who present for care with fecal incontinence.
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Antibiotics and Adverse Events: Doctors, Do No Harm
A retrospective study found that among 1,488 hospitalized patients who received an antibiotic, 298 experienced at least one antibiotic-associated adverse drug event. Furthermore, 287 of the antibiotic regimens were not clinically indicated, and 56 of these were associated with an adverse drug event.
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Update on Postpartum Hemorrhage
In the United States, postpartum hemorrhage accounts for 11.4% of maternal deaths, the fourth most common cause after cardiovascular diseases, non-cardiovascular diseases, and infection; worldwide, it is the leading cause of maternal mortality. This feature will discuss the latest treatments for managing postpartum hemorrhage.
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Hormone Replacement: Have We Made Progress Since WHI?
Vaginal estrogen may improve vaginal symptoms of menopause and does not increase the risk for endometrial cancer, stroke, or cardiovascular disease.
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Trends in OB/GYN Malpractice Litigation
In this review of medicolegal claims data from 2005-2014, obstetric and gynecologic surgery had the second highest average indemnity payment compared to other specialties, topped only by neurosurgery. Of the 10,915 claims identified, the majority (60%) were dropped, withdrawn, or dismissed; 31.1% of claims were paid by the defendant (90% before trial); and 7.5% were successfully defended by the physician.
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New Treatment Option for Women at Risk of Fragility Fractures
A randomized trial demonstrated a reduced risk of fragility fractures in high-risk women with osteoporosis treated monthly with the monoclonal antibody romosozumab compared with weekly alendronate.
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FDA Actions
In this section: FDA approves new herpes zoster vaccine, greenlights second gene therapy for cancer, and issues warnings to companies marketing cannabidiol.
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Rivaroxaban Plus Aspirin for Secondary Prevention
Among patients with stable cardiovascular disease, those assigned to rivaroxaban plus aspirin in a recent study experienced better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban alone was no better than aspirin.