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Looking Beyond LDL in Cardiovascular Risk Screening for Women

In a 30-year prospective study of nearly 28,000 initially healthy U.S. women, baseline levels of high-sensitivity C-reactive protein, low-density lipoprotein cholesterol or lipoprotein(a) independently and additively predicted major cardiovascular events.

Measles Outbreaks in the United States

Several measles outbreaks have been active in the United States, with more than 1,000 cases reported already in 2025. Most outbreaks begin as unvaccinated individuals in the United States come into contact with an infected individual who has recently arrived after international travel. Vaccination is effective, but current U.S. vaccine coverage rates are below the 95% rate considered necessary to provide herd immunity.

Update on Early Pregnancy Loss Management

Early pregnancy loss affects 15% to 20% of pregnancies and typically is diagnosed via ultrasound. Management options — expectant, medical, or procedural — should be tailored to patient preference. For medical management, mifepristone combined with misoprostol offers the highest success. Routine Rh testing before 12 weeks is no longer broadly recommended. Shared decision-making and access to effective medications remain critical.

Which Method Is Best for Assessing Fetal Well-Being During Labor?

Although this study began as a randomized controlled trial and did not show a statistically significant difference between groups for the primary outcome, pooled analysis via a meta-analysis incorporating prior pilot data suggested a potential reduction in cesarean delivery with digital fetal scalp stimulation (dFSS) compared to fetal scalp blood sampling. Secondary maternal and neonatal outcomes were similar between the two groups, both procedures were well-tolerated, and clinicians showed a clear preference for dFSS.

Lymphedema Risk After Pelvic Sentinel Lymph Node Biopsy in Endometrial Cancer

This prospective longitudinal cohort study in Denmark of women with low-grade endometrial cancer undergoing sentinel lymph node mapping during surgical staging demonstrated a statistically significant mean change in patient-reported outcome lymphedema scores from prior to surgery (5.0; 95% confidence interval, 3.3 to 6.8). However, the change did not meet preset thresholds for clinical importance (8.0 points). The study did identify body mass index (P = 0.01) and preoperative leg swelling (P < 0.01) as risk factors for lymphedema and demonstrated that this complication negatively affects several quality-of-life domains.

Assessing the Availability of Procedural, Later Abortion Services Pre- and Post-Dobbs

From 2021 to 2023, the number of publicly advertising procedural abortion facilities in the United States decreased 11%. Of those that persisted, 28% of facilities decreased their gestational age limits and 21% increased their gestational age limits.

Atrasentan Tablets (Vanrafia)

The U.S. Food and Drug Administration has approved atrasentan, the first selective endothelin A receptor (ET_AR) antagonist to reduce proteinuria in adults with immunoglobulin A nephropathy. It was approved under accelerated approval based on surrogate outcome. Continued approval may be contingent on verification of clinical benefit in a confirmatory clinical trial. Atrasentan is distributed by Novartis Pharmaceuticals Corporation as Vanrafia.

Vasectomy Follow-Up Rates: How Good Are They?

In this retrospective cohort study of 2,567 patients at a single institution, 42.1% of men did not follow up at all after vasectomy for semen analysis. Of those with spermatozoa on the initial testing post-vasectomy, 43.3% of men failed to return for repeat testing.

Best Long-Term Antiplatelet Monotherapy Post-PCI

In a multicenter, randomized, open-label trial of clopidogrel vs. aspirin monotherapy in patients post-percutaneous coronary intervention (PCI) who had been on dual antiplatelet therapy for the recommended period, those randomized to clopidogrel showed fewer major cardiovascular or cerebral events over a two-year follow-up period than those on aspirin without an increase in bleeding events.

Does Thoracentesis Speed Recovery from Heart Failure?

An unblinded, multicentered, randomized trial of patients with acute heart failure hospital admissions and significant pleural effusions showed that early thoracentesis, in addition to recommended medical therapy, did not reduce mortality or length of stay, or increase days alive out of the hospital for 90 days. However, it was relatively safe and could be employed in selected persistently symptomatic patients with very large effusions.