Clinical
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Direct Oral Anticoagulants vs. Warfarin When Treating Renal Dysfunction
A patient-level meta-analysis of five pivotal trials of direct oral anticoagulants (DOACs) vs. warfarin for patients with atrial fibrillation and creatinine clearance levels ranging from normal to 25 mL/min revealed standard-dose DOACs exhibit superior safety and efficacy compared to adjusted-dose warfarin and lower-dose DOACs.
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Valve Replacement Risk and Lifetime Management of Aortic Valve Disease
The authors of an analysis of more than 31,000 patients from the Society of Thoracic Surgeons’ database identified patients undergoing surgical aortic valve replacement (SAVR) after prior transcutaneous AVR (TAVR) or SAVR. SAVR after TAVR raised the risk of mortality vs. SAVR after SAVR.
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Cardiac MRI Predicts Outcomes in Aortic Regurgitation
Cardiac MRI could be used to make management decisions when treating patients living with chronic, asymptomatic aortic regurgitation with preserved left ventricular function, especially when trying to predict severity and possibility of adverse outcomes.
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Identifying and Testing BRCA Gene Variant Carriers Meeting NCCN Criteria
A large percentage of patients who meet criteria for breast cancer gene (BRCA) testing based on family history do not have it completed until after a personal cancer diagnosis, thus missing the opportunity for risk-reducing strategies.
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Surgical Management of Missed and Incomplete Abortion: Is Hysteroscopy Useful?
In this randomized controlled trial of 563 women comparing vacuum aspiration and operative hysteroscopy for incomplete spontaneous abortion, there was no difference in pregnancy rates within the following two years (62.8% hysteroscopy vs. 67.6% vacuum aspiration; risk difference, -4.8%; 95% confidence interval, -13% to 3%).
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Menstrual Suppression Method Outcomes Among Transgender and Gender-Diverse Adolescents
In a retrospective chart review of transgender and gender-diverse adolescents at a single institution seeking menstrual suppression methods, most individuals had high rates of method continuation, amenorrhea, improved bleeding, and a reduction in dysphoria and mood symptoms.
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Azithromycin Prophylaxis for the Prevention of Maternal Sepsis or Death in Women Undergoing Vaginal Delivery
A single oral dose of azithromycin dramatically reduced the risk of maternal sepsis or death among women planning vaginal deliveries compared to placebo but had little effect on neonatal sepsis or mortality.
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Physicians Group Creates Obesity Treatment Resources
American College of Physicians wants to expand education, advocacy, and partnerships to help clinicians care for all overweight patients.
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Clinicians Could Miss Some STI Infections Without Extragenital Screening
In this Q&A, two researchers discuss their recent study on how annual screening for urethral and rectal chlamydia and gonorrhea could be improved with extragenital screening, based on risk factors. The study population included men and women at Louisiana’s Parish Health Units.
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Online Learning Modules Helped Reduce Teen STI Rates
Researchers designed an internet-delivered program to prevent STIs and unintended pregnancies among older Black teens in Louisiana. The program, which includes eight modules, successfully engaged its audience and showed modest success at six months.