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Evidence-based updates in primary care medicine By Louis Kuritzky, MD
Supplement to Clinical Cardiology Alert, Clinical Oncology Alert, Critical Care Alert, Hospital Medicine Alert, Infectious Disease Alert, Neurology Alert, OB/GYN Clinical Alert, Primary Care Reports.
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In a large, multicenter, randomized study of women in Europe who presented with ectopic pregnancy, there was no significant difference in the rate of subsequent intrauterine pregnancy observed following early ectopic pregnancy managed with medical therapy or conservative (salpingostomy) surgery, or following acute ectopic pregnancy managed with radical (salpingectomy) or conservative surgery.
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Although users of depot medroxyprogesterone acetate (DMPA) experienced more bone fractures than users of other contraceptives, their risk of bone fractures was higher at baseline before initiating DMPA and did not change while on DMPA. This suggests that confounding, unknown factors led to the association between DMPA and fractures in previous studies.
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Overt maternal hypothyroidism and hyperthyroidism each complicate about 3/1000 pregnancies. However, subclinical hypothyroidism can accompany as many as 2.5% of pregnancies. Both problems require careful surveillance because of the potential to cause significant maternal and fetal complications.
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OB/GYN Clinical Alert editorial board transitions.
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In a prospective cohort of obese, reproductive-aged women, there were no changes in the number of ovulatory cycles, but there was a shortening of the follicular phase and an improvement in sexual function after gastric bypass surgery.
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LAP2 was a phase 3 clinical trial to assess the non-inferiority of laparoscopy compared with laparotomy for recurrence of uterine cancer after surgical staging.
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During the past few months, there has been a pleth-ora of articles published with important clinical implications, and I have found it difficult to pick just one to review.