Clinical
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SGLT2 Inhibitor Plus Aldosterone Antagonist for HFpEF: Safe? Efficacious?
A prospective, open-label, blinded outcome crossover trial of dapagliflozin plus spironolactone vs. dapagliflozin alone in patients with heart failure with preserved or mildly reduced left ventricular ejection fraction resulted in a greater reduction in natriuretic peptides, which was accompanied by a greater decline in kidney function and a rise in serum potassium.
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ApoB vs. Lp(a): Which Is More Important for CAD Risk?
In U.K. Biobank participants without known atherosclerotic cardiovascular disease or diabetes or taking lipid-lowering therapy, the risk of developing coronary artery disease is best determined by apolipoprotein B particle number, but elevated lipoprotein(a) adds significant risk, so both should be considered.
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The Proton Pump Inhibitor Use and Hypertension Link in Menopausal Women
In a large study, long-term use of proton pump inhibitors in menopausal women was associated with an increased risk of developing hypertension.
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The Walk ’n Watch Trial: Stroke Recovery Through High-Intensity Walking
An intensive real-life walking protocol, started as soon as possible after acute stroke, resulted in improved overall walking endurance, mobility, balance, and quality of life.
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Clinical and Genetic Reassessment of Patients with Presumed Hereditary Polyneuropathy
This is an observational, cross-sectional study of patients seen at a specialized neuromuscular center with a clinical diagnosis of hereditary polyneuropathy, without a previously identified genetic diagnosis. The goal of this study was to assess the combination of clinical reassessment with updated genetic testing, including whole genome sequencing. Reassessment improved the diagnostic clarification rate in these patients.
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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.
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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.
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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.
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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.
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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).