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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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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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Five-Year TAVR vs. SAVR Data Show Encouraging Results, but Do Not Move the Needle for Clinical Decision-Making
The PARTNER 3 trial randomized low-risk patients to transcatheter aortic valve replacement vs. surgical aortic valve replacement. Five-year data show no significant differences in the composite endpoint of death, stroke, or rehospitalization.
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Superinfection of Hepatitis B and Hepatitis D on the Horizon
Called a satellite virus, hepatitis delta virus (HDV) is making an outsized impact on liver disease and cancer worldwide. HDV only appears alongside a hepatitis B infection, and people living with HIV infection are particularly at risk of the disease.
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Clinicians Should Develop Sexual Health Screening Soft Skills
At a time when STIs are on the rise, all providers need to develop skills in sexual health screening. New research shows these skills are lacking among many physicians, and there are other barriers to screening patients for STI risk factors.
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CDC Issues New Guidance on Using Doxycycline for PEP
The Centers for Disease Control and Prevention recently published proposed guidelines for the use of doxycycline post-exposure prophylaxis for preventing bacterial sexually transmitted infections.
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Incarcerated People Face Nearly Insurmountable Odds of Maintaining Reproductive Autonomy
About one out of six incarcerated pregnant people may need an abortion in the coming years. But their ability to access that care is blocked or nearly blocked in states with abortion bans and major restrictions, according to the authors of a recent study.
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Progestin-Only Birth Control Is Safe for Breastfeeding Mothers
Reproductive health organizations should consider updating contraceptive counseling guidelines for patients who are breastfeeding to reflect that it is safe for them to use progestin-only contraceptive methods, according to the authors of a recent paper.
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Telemedicine Abortion Services Not as Accessible to Many in Need
Medication abortion through telehealth services has grown dramatically in the past couple of years, but it is not accessible to everyone who may need the service. For example, younger people, those with health conditions, and those with limited English proficiency are less likely to use telemedicine abortion services.
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Levonorgestrel IUDs and Combined Oral Contraceptives Alleviate Menstrual Bleeding
Women with concerns about menstrual bleeding could improve their bleeding-related quality of life with either the levonorgestrel intrauterine device system or combined oral contraceptives at six or 12 months, new research shows.