Clinician.com

Treatment Window for Lowering Blood Pressure in Acute ICH

Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.

Routine Boosting Against Tetanus and Diphtheria in Adults: A Time to Reconsider

Slifka and colleagues make a strong argument against the routine booster vaccination of adults against tetanus and diphtheria as recommended by the Centers for Disease Control and Prevention.

MIND Matters: Diet, Exercise, and Engagement in Cognitive Health

This multicenter, randomized clinical trial showed that a highly structured, multidomain lifestyle intervention modestly but significantly was associated with improved global cognitive function throughout two years in at-risk older adults, compared to a lower-intensity, self-guided program.

Gabapentin and the Risk of Dementia in Adults with Chronic Pain

In a retrospective cohort study, gabapentin prescription in adults with chronic low back pain was associated with increased risk of dementia and cognitive impairment, particularly in non-elderly adults.

Managing Suspected Preeclampsia Using the sFlt-1/PlGF Ratio

The sFlt-1/PlGF ratio is a clinically valuable tool for ruling out preeclampsia and improving obstetric decision-making, although its effect depends on appropriate use, clinician confidence in negative results, and adherence to validated protocols.

Endometrial Biopsy: What Leads to an Insufficient Sample?

In this large retrospective cohort study at a single health system, the rate of insufficient endometrial biopsies among 27,456 patients was 12.1%. The largest risk factor for an insufficient sample was postmenopausal status (adjusted odds ratio, 5.27; 95% confidence interval, 4.88-5.70). Among premenopausal women, a history of cesarean delivery (9.6% vs. 7.2%; P < 0.001) and leiomyomas (10.3% vs. 7.2%; P < 0.001) was associated with insufficient samples.

Is Routine Voiding Necessary Following Minimally Invasive Hysterectomy?

This unblinded, randomized clinical trial of patients undergoing minimally invasive benign nonurogynecologic hysterectomy with anticipated same-day discharge demonstrated that eliminating the requirement to void prior to discharge reduced time spent in the post-anesthesia care unit by 27.14 minutes (173.26 mins no void vs. 201.95 mins void; P = 0.002) without increasing the proportion of patients with postoperative urinary retention (3% void vs. 1% no void; P = 3.69).

A Closer Look at a New Low-Dose Copper IUD

This study reports on the three-year data from an ongoing Phase III study evaluating the efficacy, safety, and tolerability of a new low-dose copper intrauterine device (IUD), demonstrating low rates of expulsion and discontinuation and expanding the nonhormonal IUD options available in the United States.

Addressing Patient Opioid Use Disorder in Primary Care

Primary care providers (PCPs) play a critical role in diagnosing and treating opioid use disorder (OUD). By approaching OUD as a chronic disease, using non-stigmatizing language, and integrating team-based care, PCPs can provide accessible, effective treatment.

Abortion-Providing Clinicians Are Shifting Careers and Locations to Meet Needs

Clinicians in the study included nurses, advanced practice practitioners, and clinicians in family medicine.

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