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Clinical Insights on Managing DPN and PAD in Patients with Diabetes

Given the significant prevalence of diabetes in the population, it is important for the primary care clinician to be familiar with the many types of neuropathies commonly affecting people living with diabetes. By far the most prevalent type is chronic diabetic peripheral sensorimotor neuropathy, affecting up to 50% of people with diabetes. Peripheral arterial disease (PAD) refers to partial or complete occlusion of peripheral vessels of the lower extremities. The underdiagnosis of PAD in the primary care setting may be a major issue because of many patients presenting without the typical claudication symptoms described in medical textbooks. The ability of primary care clinicians to diagnose PAD in asymptomatic patients still has a significant clinical effect because PAD acts as a marker for systemic atherosclerosis.

Stroke 2025 Is Here!

Stroke 2025: Optimizing Outcomes with Clinical Approaches provides evidence-based, cutting edge, clinical information on treating stroke and other neurological problems in a concise, accurate, and clinically relevant format. Written and edited by leading experts in the fields of neurology and emergency medicine, Stroke 2025 is an unbiased resource for any physician or nurse working in an emergency department or stroke center. Healthcare providers can earn all of the Joint Commission-required stroke credits at one time through this electronic publication.

Clinical Consequences of Alzheimer’s and Lewy Body Co-Pathologies

This large study of patients with cognitive impairment-assessed cerebrospinal fluid biomarkers, positron emission tomography imaging, and cognitive tests showed that those with evidence of both Alzheimer’s and Lewy body pathologies had greater cognitive dysfunction and faster progression than those with either pathology alone.

Long-Term Efficacy of Ocrelizumab as First-Line Treatment for Relapsing-Remitting Multiple Sclerosis

Nine-year follow-up data from open-label extension of the Phase III clinical trials of ocrelizumab show that, although the efficacy of ocrelizumab was maintained throughout the duration of the study, patients who were treated with ocrelizumab from the beginning of the Phase III trials did better than the patients who were on subcutaneous (SC) interferon β-1a initially and were switched to ocrelizumab at the onset of the open-label extension period.

Small Fiber Neuropathy in Post-COVID Patients with Chronic Fatigue Syndrome

This study examines small fiber neuropathy (SFN) in post-COVID patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). While ME/CFS patients reported more SFN symptoms, objective testing showed limited diagnostic value beyond heat/cold detection differences.

Should Thrombolytic Drugs Be Added to Mechanical Thrombectomy in Acute Stroke?

Two recent trials from China studied the effect of post-thrombectomy, intra-arterial thrombolysis on neurological outcomes. One study used tenecteplase and the other used urokinase. Both studies showed a trend toward improvement that was not statistically significant, and there was an increase in brain hemorrhage. The benefit of adjunctive thrombolysis with mechanical thrombectomy is uncertain and requires more study.

Should Trial of Labor Be Offered to Women with Two Previous Cesarean Deliveries and Twin Gestations?

In twin pregnancies among women with two prior cesarean deliveries, there were no significant differences observed in adverse maternal or neonatal outcomes, yet the probability of a successful vaginal birth stood at 37.8%.

Modified Laparoscopic Radical Hysterectomy in Early-Stage Cervical Cancer

In this retrospective cohort study including 276 patients with early-stage cervical cancer, modified tumor-free techniques during laparoscopic radical hysterectomy, including avoidance of a uterine manipulator and vaginal closure prior to colpotomy, demonstrated a lower recurrence rate (1.3% vs. 12.8%) and significantly better two-year disease-free survival (99.3% vs. 91.9%, P = 0.002) compared with traditional laparoscopic radical hysterectomy.

Trends in Contraceptive Use Among Abortion Patients

In this cross-sectional study of 88,550 patients presenting for abortion services in England and Wales in 2018 and 2023, the use of effective methods of contraception decreased over time (hormonal methods: 18.8% vs. 11.3%, P < 0.001; long-acting reversible contraceptives: 3% vs. 0.6%, P < 0.001), while fertility awareness-based methods increased from 0.4% to 2.5% (P < 0.001).

New Guidelines for HPV Testing of Self-Collected Vaginal Specimens

This article outlines national consensus guidelines for the use of human papillomavirus (HPV) testing of self-collected vaginal specimens for cervical cancer screening.