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Vaccination has dramatically reduced the number of cases of chickenpox, measles, polio, mumps, and pertussis treated in primary care settings. Antibiotic treatment of streptococcal pharyngitis has reduced the number of cases of rheumatic fever. As a result, there are generations of physicians who have never encountered patients with these diseases. These diseases are often relegated to the historical section of general medical textbooks. However, recent isolated outbreaks in adults as well as children have brought these diseases back into the forefront for primary care providers.
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We all know that we should be drinking more green tea; every few days, either the media or medical journals are touting a new use for the Asian staple. Can it really cure breast cancer while preventing liver disease, simultaneously increasing knee range of motion in people suffering from osteroarthritis? The answer is "possibly, yes," but an evidence-based review refines the glowing reports with some clinical pearls, dosing specifics, and hopeful avenues of future research, as detailed below.
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A randomized controlled trial of weekly clinical hypnosis sessions plus home self-hypnosis practice over 5 weeks for breast cancer survivors with hot flashes resulted in significant symptomatic improvement when compared to a matched group of women who received no additional treatment.
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A prospective, randomized controlled trial measured the impact of a low-fat diet that included high levels of omega-3 fatty acids from fish oil on biomarkers for prostate cancer. No significant differences were found for the primary outcome during an interim analysis and the trial was stopped early. Analysis of secondary endpoints showed some significant differences between the groups, although other biomarkers did not differ.
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It has been well recognized that a peak in stroke onset occurs during the early morning hours. This possible circadian periodicity is not well understood, and may in part represent stroke onset earlier during the night that goes unrecognized until the patient arouses.
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In nonvalvular atrial fibrillation patients, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism. However, an intention-to-treat analysis did not show superiority of rivaroxaban over warfarin.
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For many patients with moderate- severe chronic obstructive pulmonary disease, acute exacerbations (AECOPD) are highly problematic.
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Both urgency and bladder pain can lead to nocturia in patients with interstitial cystitis.
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A kinase inhibitor for late-stage melanoma and its companion diagnostic test have been approved by the FDA.
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The authors conclude that this large observational study suggests ACEI or ARB therapy is associated with an improved survival and a lower risk of cardiovascular events in patients with aortic stenosis.
