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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.

EEG in Patients with Disorders of Consciousness

Abnormal background continuity, ictal-interictal continuum features, and an unreactive electroencephalogram (EEG) background were independently associated with unfavorable outcomes in the overall cohort of patients with acute brain injuries. In addition, an unreactive EEG predicted unfavorable outcomes at six months with high specificity across multiple patient subgroups. However, the sensitivity of unreactive EEG for predicting unfavorable outcomes was low.

Giant Cell Arteritis Has New Options for Steroid-Sparing Therapy

The SELECT-GCA Study trial of patients with giant cell arteritis found that upadacitinib at 15 mg daily combined with a 26-week glucocorticoid taper showed efficacy superior to placebo treatment with a 52-week glucocorticoid taper. The 15-mg dose of oral upadacitinib added to a shorter steroid treatment regimen was well-tolerated and appeared to be safe, as compared to placebo treatment with a longer period of steroid treatment.

Updates on Cervical Cancer Prevention: Summary and Projected Effect

HPV vaccination and updated screening strategies offer OB/GYN providers powerful tools to prevent cervical cancer. Recent advances, risk-based management, and enhanced follow-up can provide targeted care for high-risk patients to reduce the incidence of cervical cancer while avoiding unnecessary procedures.

Postoperative Antibiotics After Cesarean Delivery to Reduce SSI

This randomized, double-blind clinical trial including 321 women with a pre-pregnancy body mass index > 30 kg/m² demonstrated no difference in surgical site infection composite between participants receiving oral cephalexin and metronidazole for 48 hours after cesarean delivery compared to placebo (5.6% vs. 6.8%; odds ratio, 0.80; 95% confidence interval, 0.33-2.22; P = 0.64).

Adverse Outcomes in Women with a History of Recurrent Pregnancy Loss

Women with a history of recurrent pregnancy loss are at significantly increased risk of adverse outcomes, including preeclampsia, placental abruption, cesarean delivery, preterm birth, stillbirth, and perinatal mortality.

What Is the Genitourinary Syndrome of Lactation?

In this systematic review of 65 studies, the prevalence of vaginal atrophy among postpartum breastfeeding patients was 63.9% (95% confidence interval [CI], 55.3% to 71.6%) and vaginal dryness symptoms occurred in 53.6% (95% CI, 33.6% to 72.5%). Dyspareunia also was elevated, with a prevalence of 60.0% at three months, (95% CI, 45.1% to 73.3%), 39.7% at six months, (95% CI, 28.9% to 51.5%), and 28.5% at 12 months (95% CI, 26.3% to 30.9%).

Contemporary Cardiovascular Disease Deaths in Asian Americans

An analysis of a Centers for Disease Control and Prevention database has shown the cardiovascular disease mortality rate is higher in Asian Americans than in non-Asian Americans and that this excess mortality is particularly prevalent in Filipino Americans.

Surgery or Fibrinolysis for Thrombosed Mechanical Valves

A randomized trial of urgent surgery vs. thrombolytic therapy for symptomatic left-sided mechanical valve thrombosis has shown that surgery completely restores valve function in all patients compared to three-quarters of patients with thrombolytic therapy, but at a cost of higher in-hospital complications and mortality.

Left Ventricular Size and Outcomes in Aortic Regurgitation

A multinational, retrospective, observational registry study of patients with significant aortic valve regurgitation has shown that left ventricular end-systolic dimension and volume measurements are valuable for risk-stratifying such patients and should be incorporated into the guidelines for when to intervene.