Clinical Publication
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Evaluating the Effectiveness of Treatment Strategies for Managing Cesarean Scar Ectopic Pregnancies
A review of 460 international cases of cesarean scar pregnancies demonstrated that surgical treatments were extremely effective options, with successful completion in 91.5% (95% confidence interval [CI], 87.8 to 95.2) of suction evacuations and 91.8% (95% CI, 83.8 to 99.9) of surgical excisions compared with a lower success rate for medical options, including local gestational sac injection or systemic methotrexate.
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The Effect of a Full Bladder on Endometrial Biopsy Success in the Office
In this randomized controlled trial of 214 patients, those with a full bladder prior to Pipelle endometrial biopsy had lower first insertion failure rates without the use of a tenaculum (23.4% vs. 42.1%) compared to those with bladder status not taken into account.
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A Tubal Sterilization Knowledge and Decision Aid Support Tool: Does it Make a Difference?
A patient-centered decision aid that improves tubal sterilization knowledge and decision-making quality may be able to fill gaps in counseling and supplement the existing Medicaid sterilization consent process.
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Elafibranor Tablets (Iqirvo)
The U.S. Food and Drug Administration has approved an oral dual peroxisome proliferator-activated alpha and delta receptor agonist for the treatment of primary biliary cholangitis, formerly known as primary biliary cirrhosis. Elafibranor was granted an accelerated approval and an orphan designation.
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Racial Inequities in Shared Decision-Making for Critically Ill Patients
In this thematic analysis of a previously conducted randomized clinical trial, disparate shared decision-making behaviors were observed among meetings with white vs. Black caregivers of critically ill patients, illustrating opportunities for future clinician-level interventions.
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Is Artificial Intelligence Coming for Your Job?
A retrospective analysis of plain chest X-ray images in the medical record using deep learning in patients suitable for risk assessment for atherosclerotic cardiovascular disease (ASCVD) has shown similar results as the American College of Cardiology/American Heart Association ASCVD risk calculator for determining who is at sufficient risk to consider statin therapy.
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Empagliflozin Post-Acute Myocardial Infarction
A prespecified further analysis of the EMPACT-MI trial has shown that patients within two weeks of an acute myocardial infarction who are at risk for heart failure who receive empagliflozin compared to placebo have significantly fewer episodes of heart failure hospitalizations over a median follow-up of 18 months.
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Utility of Electromyography in the Diagnosis of Rhabdomyolysis
Electromyography often is requested in the evaluation of a patient with rhabdomyolysis. It often shows evidence of “myopathy,” but muscle biopsies frequently are non-confirmatory, and genetic testing often is needed for a definitive diagnosis.
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Acute Clinical Worsening Without MRI Changes in Multiple Sclerosis
Patients with multiple sclerosis (MS) can have an acute clinical event suggestive of a relapse, but their magnetic resonance imaging (MRI) shows no corresponding changes (labeled by the authors as an acute clinical event with stable MRI [ACES]). These events have not been systematically analyzed. The authors reported that this number is significant, and a quarter of the relapses reported by patients fall under this category. Patients with ACES had higher relapse rates and a greater risk of transition to secondary progressive MS.
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Are New-Onset Seizures Associated with SARS-CoV-2 Vaccines?
In this meta-analysis, there was no statistically significant difference in the risk of new-onset seizure incidence between vaccinated individuals and placebo recipients in the 28-day post-injection period. Similarly, in the post-injection entire blinded phase (median follow-up 148, 121, and 43 days in three trials), no significant difference was observed between the vaccine and placebo recipients regarding the incidence of new developing seizures.