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Comparison of the Mini and Standard Copper IUD
This Phase III randomized clinical trial demonstrated a three-year cumulative pregnancy rate of 4.8% (95% confidence interval, 2.75 to 6.86) for the NTCu380 mini intrauterine device (IUD), with similar discontinuation rates between the mini copper IUD and the TCu380A standard copper IUD (51.3% vs. 57.3%, P = 0.07), but fewer discontinuations for bleeding and pain for the mini copper IUD (14.5% vs. 27.3%, P < 0.001).
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Antenatal Corticosteroids for the Periviable Fetus at 22 Weeks of Gestation
The 2021 American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine practice advisory significantly increased the use of antenatal corticosteroids at 22 weeks of gestation in U.S. hospitals planning neonatal resuscitation, highlighting both the powerful influence of clinical guidelines on practice patterns and the persistence of disparities driven by sociodemographic factors.
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What Is the Risk of CT Exposure Before Conception?
In this retrospective cohort study among 5,142,339 pregnancies in Ontario, Canada, exposure to preconception computed tomography (CT) was weakly associated with spontaneous pregnancy loss (adjusted hazard ratio [aHR], 1.08; 95% confidence interval [CI], 1.07 to 1.08 for one CT scan; aHR, 1.14; 95% CI, 1.12 to 1.16 for two CT scans; and aHR, 1.19; 95% CI, 1.16 to 1.21 for three or more CT scans). For the 3,451,968 live births, there was a similar weak association with congenital anomalies (aHR, 1.06; 95% CI, 1.05 to 1.08 for one CT scan; aHR, 1.11; 95% CI, 1.09 to 1.14 for two CT scans; and aHR, 1.15; 95% CI, 1.11 to 1.18 for three or more CT scans).
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Wellens’ Syndrome or Not?
Today’s patient is a middle-aged man who presented to the emergency department (ED) with a history of chest pain with exertion during the past two weeks. His chest pain had been increasing and was at its most severe level the day he presented to the ED. The initial serum troponin level in the ED was more than 10,000 ng/L. Does the clinical scenario suggest Wellens’ syndrome?
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Rilzabrutinib Tablets (Wayrilz)
The U.S. Food and Drug Administration has approved rilzabrutinib, the first-in-class Bruton’s tyrosine kinase inhibitor, for the treatment of persistent or chronic immune thrombocytopenia. Rilzabrutinib is distributed by Genzyme Corporation as Wayrilz.
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Increased Treatment Opportunities for Trigeminal Autonomic Cephalalgias
Trigeminal autonomic cephalalgias (TACs) include cluster headache, paroxysmal hemicrania, hemicrania continua, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing, and short-lasting unilateral neuralgiform headache with cranial autonomic symptoms. They are female-predominant primary headache disorders that coexist with migraines and mood disorders. Indomethacin is underused in those TACs that are specifically indomethacin responsive. Noninvasive vagus nerve stimulation for TACs is well-tolerated and more effective for prevention than as an acute treatment.
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Pertussis: Concerning News from Mexico, Brazil, and China
Related to under-immunization of pregnant women and children, pertussis is spreading in several countries within the Americas. Macrolide resistance of Bordetella pertussis is now common in China.
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Preventing SARS-CoV-2 Infection with an Allergy Nasal Spray
Use of the antihistamine azelastine nasal spray was effective in preventing SARS-CoV-2 infection in young, healthy, vaccinated outpatients.
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Patients Aged 6 Months and Older with Egg Allergy Should Receive Flu Vaccine
The Advisory Committee on Immunization Practices (ACIP) provided updated guidance for the 2025-2026 influenza season. After reviewing data on egg-based influenza vaccines, ACIP reinforced that individuals with egg allergies are not at increased risk of severe allergic reactions and outlined precaution and contraindication considerations in vaccine administration for this population.
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Cost and Other Economic Factors Affect People’s Access to Contraceptives
New research examines how contraception costs can affect young people’s decision-making about whether to use contraception.