Articles Tagged With: asymptomatic
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CREST-2 Boosts Modern Medical Therapy for the Initial Treatment of Asymptomatic Carotid Stenosis
CREST-2 consisted of two parallel randomized trials in patients with ≥ 70% asymptomatic carotid stenosis, showing that intensive medical therapy alone produced very low stroke rates, with no significant additional benefit from carotid endarterectomy and a modest absolute risk reduction with carefully performed transfemoral carotid stenting over four years. These findings support intensive risk factor control as the default strategy and suggest reserving revascularization for highly selected patients at experienced centers.
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Antibiotics for Asymptomatic Bacteriuria: Using Urinalysis to Improve Stewardship
A cohort study found that in patients receiving antibiotics for a urinary tract infection, a urinalysis with pyuria and/or nitrituria identified 40% more cases of unnecessary antibiotic use compared to asymptomatic bacteriuria.
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New Indications for Aortic Valve Replacement in Chronic Aortic Regurgitation
A retrospective observational study of asymptomatic patients with isolated moderate to severe or severe aortic valve regurgitation by echocardiography has shown that left ventricular (LV) ejection fraction (EF) < 60%, LV end systolic volume index > 45 mL/m², or global longitudinal strain less than -15% is associated with all-cause mortality, but mortality is highest when current guideline recommendations are present. This suggests that there is a survival penalty with the sole use of the current guidelines.
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A New Technique for Predicting Outcomes in Asymptomatic AS
An international study of patients with moderate or asymptomatic severe aortic stenosis has demonstrated that increased amounts of left ventricular fibrosis, as measured by cardiac magnetic resonance imaging, is associated with worse outcomes.
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Pelvic Exams During Annual Gynecologic Visits
A retrospective chart review of 1,121 patients undergoing annual gynecology exams showed that 1.2% (95% confidence interval [CI], 0.5 to 1.9) of asymptomatic patients had physical exam findings on pelvic exam compared to 32.4% (95% CI, 27.0 to 37.8) of symptomatic patients.
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Is Screening First-Degree Relatives of Cardiomyopathy Patients Worthwhile?
An observational study of screening first-degree relatives of patients with dilated cardiomyopathy revealed 14% will show either dilated left ventricles, low left ventricular function, or both. These findings are more common if the relatives have been diagnosed with hypertension or are obese, but their frequency is not altered by sex or race.
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Improve Screening and Retesting for Trichomoniasis
Infection by the protozoan Trichomonas vaginalis is the most common nonviral sexually transmitted infection, with an estimated 6.8 million cases in the United States annually. It can go undiagnosed because most infected people (up to three out of four) do not experience symptoms. Left undiagnosed and untreated, trichomoniasis can increase the risk of pelvic inflammatory disease, infertility, and acquiring HIV and other STIs.
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Antibiotic Stewardship vs. Diagnostic Stewardship for Reducing Unnecessary Antibiotics in Asymptomatic Bacteriuria
A statewide quality study compared antibiotic stewardship to diagnostic stewardship for hospitalized patients with asymptomatic bacteriuria. It found that reducing urine cultures decreased unnecessary antibiotic prescribing better than antibiotic stewardship.
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FDA Streamlining COVID-19 Shot to a Single Formula
Conceding the various vaccine doses and multiple boosters have caused considerable confusion, and some degree of pandemic apathy, the FDA’s Vaccines and Related Biological Products Advisory Committee unanimously voted to simplify and “harmonize” the process by switching to a single vaccine formula to be administered annually for most people.
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SHEA Outlines Research Agenda for COVID-19, Future Viral Pandemics
Looking to future viral pandemics as well as the current one of COVID-19, the Society of Healthcare Epidemiology of America has set an ambitious research agenda to improve preparation and response to these cataclysmic events.