Internal Medicine
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The Trouble with Electronically Tracking Study Medications
Digital pills allow data to be recorded automatically about patients’ medication adherence, but patients and providers have expressed significant ethical concerns.
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Be Careful About Informed Consent if Pelvic Exams Happen While Patients Are Under Anesthesia
Incorporate explicit discussions with patients about pelvic exams conducted while patients are under anesthesia. These discussions should occur during consent processes for gynecologic procedures. Specifically, patients would be told about the potential for medical student involvement in these exams.
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Updated Tactics for Parkinson’s Disease Study Recruitment
Remote, decentralized studies allow for the recruitment of large, geographically dispersed cohorts from a single location. In considering whether to use a decentralized design or to include remote assessments, the research team must determine if these methods can adequately answer the question under study.
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Are SGLT2 Inhibitors Effective for HFpEF Patients Without Diabetes?
After comparing empagliflozin vs. placebo for patients with heart failure and preserved left ventricular ejection fraction, researchers found no differences in the significant reduction of the primary outcome of cardiovascular death or heart failure hospitalization over 36 months based on whether patients were diabetic.
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Predicting the Tolerability of Sacubitril/Valsartan in Advanced Heart Failure
An analysis of the sacubitril/valsartan run-in period for chronic, advanced heart failure patients showed 18% could not tolerate the lowest dose, usually because of hypotension or renal dysfunction. Investigators identified six predictors of non-tolerance, which may help clinicians choose the best candidates.
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Provocative Testing with Intracoronary Acetylcholine as Part of Cardiac Catheterization Evaluation
In this systematic review and meta-analysis of invasive coronary provocation testing, intracoronary acetylcholine was found to be a safe procedure, with low rates of major complications.
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Clinical Significance of Mitral Annular Calcification
Researchers found mitral annular calcification to be uncommon, and few experience associated moderate to severe mitral stenosis or regurgitation. However, the latter group recorded a high mortality rate over three years follow-up, which was significantly lower in those who underwent valve interventions, even when corrected for younger age, fewer comorbidities.
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Appropriate Management of Thoracic Aortic Aneurysms
Among patients with arch and descending thoracic aorta aneurysms followed over a mean 20 months, aneurysm-related mortality was predicted by the size and growth rate of the aneurysms, along with age and sex.
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COVID-19: Duration of Shedding of Transmissible Virus
Patients with COVID-19 were found, by culture, to shed replication-competent virus after an initial PCR test for median durations of four to five days.
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COVID-19 Rebound
Symptomatic and virologic recrudescence after treatment of patients with COVID-19 with Paxlovid occurs in a tiny percentage of patients and generally is mild and self-limited.