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Use of antiretroviral therapy has led to a major decline in perinatal infections, but the regimen with the best safety profile is still not known. The literature on ART and pregnancy outcomes is reviewed. https://nej.md/3H5fNYT
The use of a motion-based digital therapeutic device to guide pelvic floor muscle training led to greater improvement of urinary incontinence symptoms for up to 12 months compared with standard self-guided exercises, a recent study reported. https://ja.ma/3H7NBoc #MedicalNews
Conscious sedation is not better than general anesthesia for functional independence in patients with acute posterior circulation during endovascular therapy. #Research https://ja.ma/3wIys8i
This study describes a cohort of 7 patients with SCoRCH (Sudden Conjunctivitis lymphopenia and Rash Combined with Hemodynamic changes) which developed within 2 weeks of Trimethoprim-sulfamethoxazole use. https://ja.ma/3HevfmL
This review presents consensus recommendations about critical elements of trial design for evaluation of novel treatments of opioid use disorder. https://ja.ma/3vHAzIE
Study of patients with papillary thyroid carcinoma and lymph node metastases found that recurrence-free survival was similar after lobectomy and total #thyroidectomy. https://ja.ma/3k6yqE0
Medical News in Brief: Gender-Affirming Hormones and Youth Well-being https://ja.ma/3ZZEQ8l
Patients with Cystic fibrosis treated with elexacaftor-tezacaftor-ivacaftor may develop acneiform eruptions with a specific histologic pattern of necrotizing infundibular crystalline folliculitis. https://ja.ma/3XGAEZ8
Study by @AZTraumaCats comparing pelvic fracture hemorrhage control interventions, >1/3 of pts died despite advancements in hemorrhage control strategies. Only pelvic angioembolization was assoc'd w reduction in mortality. @TopKniFe_B @TanyaAnand8 https://ja.ma/3Xka73K
#Viewpoint summarizes several federal strategies to ensure pregnant persons’ access to abortion services after the recent Supreme Court ruling in Dobbs v Jackson Women’s Health Organization. https://ja.ma/3XO8L1X
Study results suggest that a shared profile of quantitative plasma lipid alterations is characteristic of population-diverse individuals affected by severe mental disorders. https://ja.ma/3wrPreM
Challenges in Clinical Electrocardiography: A patient in their 80s w/ history of paroxysmal Afib presented with palpitation, dizziness, nausea, vomiting. A 12-lead ECG was obtained. What is the ECG diagnosis? How should this patient’s treatment be managed? https://ja.ma/3WTFXDH
Large cohort study of pts w/advanced NSCLC showed rapid integration of immune checkpoint inhibitor immunotherapy across all age groups after FDA approval, but improvements in survival were seen in younger patients & not observed in pts 75 & older. https://ja.ma/3j5XHhp #LCSM
Public health policies should consider FTLD-associated disorders as more common than previously described, & FTLD diagnosis should be considered at any age. https://ja.ma/3kJ35Yg @BarbaraBorroni7 @SoljeEino @CambridgeFTD @RemesAnne @alessandro5161 @JohannaKrger2 @mpiccininni3
Modified Atkins diet may have better tolerability and higher probability of short-term seizure reduction than ketogenic diet. https://ja.ma/3WOPnQU
BREAKING: President Joe Biden informed Congress on Monday that he will end the twin national emergencies for addressing COVID-19 on May 11, as most of the world has returned closer to normalcy nearly three years after they were first declared. https://apnews.com/article/biden-united-states-government-district-of-columbia-covid-public-health-2a80b547f6d55706a6986debc343b9fe
In this Viewpoint, @donberwick explores the pursuit of profit in US health care across sectors—such as pharmaceutical companies, insurers, hospitals, and physician practices—and its harms to patients, and then offers potential solutions. https://ja.ma/3HmDCvo
Will renewed efforts get naloxone directly to those who need it, not just the first responders? @geoffmulvihill explores this important question
https://apnews.com/article/naloxone-narcan-overdose-availability-ec12f62eef12ebc67de77afdbb6f11b9
"LTL was not. Thus we dismiss its petition." (3)
The proceedings could have implications for companies increasingly seeking to implement the legal maneuver come to be known as the "Texas Two-Step." Some background here: https://www.wbur.org/onpoint/2022/10/20/the-texas-two-step-a-new-bankruptcy-strategy-to-avoid-corporate-liability
Appeals court: "Good intentions—such as to protect the J&J brand or comprehensively resolve litigation—do not suffice alone. What counts to access the Bankruptcy Code’s safe harbor is to meet its intended purposes. Only a putative debtor in financial distress can do so..." (2)
Third U.S. Circuit Court of Appeals dismisses J&J's chapter 11 case today, where the company was seeking to put its talc liabilities into bankruptcy as a separate corporate entity. J&J says it plans to challenge the ruling. (1)
A new study suggests that pre-hospital point-of-care troponin and paramedic risk stratification for patients with acute chest pain could result in substantial cost savings provided safety is confirmed in prospective studies https://ja.ma/3kRWJWO
Study results suggest that having autism may be associated with a higher risk of developing diabetes, dyslipidemia, and heart disease. https://ja.ma/3Ds52Pj
In a large cohort of patients with stage III colon cancer, investigators found that elevated inflammatory biomarkers (IL-6, sTNF-αR2, and hsCRP) after diagnosis were associated with worse survival. https://ja.ma/3kN1GQm
In this randomized clinical trial of patients 65 years or older with vascular risk factors, a polypill, with or without aspirin, was not associated with reduced cognitive outcomes but was associated with reduced functional decline. https://ja.ma/3wKMpCk
Integrating recent molecular, cellular, and anatomical findings in schizophrenia, this article hypothesizes why there is too much glutamate in the disordered hippocampus, a hypothesis that can explain clinical symptoms and guide novel drug discovery https://ja.ma/3wq6ZrP
Study found an association between implementation of clinician-initiated billing and an increase in e-visits, but adoption was low. https://ja.ma/3Wyurhc
An #AdvancedPractitioner-driven #fertility preservation initiative resulted in a more than two-fold increase in referrals for consultation with a reproductive endocrinologist among adolescents and young adults with #cancer at risk for #infertility https://loom.ly/lED23Ls
From the NEJM Archive: In this Original Article from January 11, 1940, the authors discuss how "cardio-omentopexy, when feasible, is the operation of choice for the establishment of a new blood supply to the heart by surgical means." https://nej.md/3j7LCs8
Research Summary: Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest
https://nej.md/3J8rsbW
#Viewpoint examines in-depth 5 features of health care systems that may influence quality of care: pooled resources, centralization, standardization, interprovider coordination, and cross-practice learning. https://ja.ma/3R09fiV
When a physician makes an ill-advised promise to her brother, a neonatologist rethinks her own experiences promising parents outcomes she can neither control nor guarantee — and the effects on trust. https://nej.md/3kIoukg
In this cohort study, half of patients with catastrophic APS (CAPS) showed cutaneous involvement, with a spectrum of clinical presentations, including distal inflammatory edema. Skin biopsies confirmed diagnosis in all but 1 biopsied patient. https://ja.ma/3ko5Huw
People with type 2 diabetes who ate a low-carb, high-fat diet for 6 months had better glycemic control than those who ate a high-carb, low-fat diet, a recent trial reported, but the differences weren’t sustainable 3 months after the intervention https://ja.ma/3ZWPBbv
In this study of patients with localized #PancreaticCancer treated with neoadjuvant therapy and node negative disease, adjuvant therapy was associated with a significant improvement in progression-free & overall survival. @UPMC #Research #PanCan https://ja.ma/3GBM0qD
Podcast discussion of the Article
https://thelancetpsychiatry.buzzsprout.com/1391365/12130777-richard-morriss-on-cranial-electrostimulation-therapy-for-depression
"future research investigating home-based neuromodulation in depression should explore other key considerations, including the mechanistic basis of neuromodulation effects"
Comment linked to the Article
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00028-7/fulltext
"Both active and sham Alpha-Stim AID treatment regimens were associated with clinically important decreases in the primary depression score...8 weeks after the end of treatment."
New research Article
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00007-X/fulltext
1 in 4 patients with colorectal cancer in the UK bypassed their nearest surgical center for treatment, attracted to centers offering robotic surgery and avoiding centers w low quality ratings. Younger, affluent patients were more likely to travel for care. https://ja.ma/3GC3TWa
Extracutaneous exposure to allergens in individuals with previous contact sensitization can provoke systemic contact dermatitis , which may present with varied morphologies, including morbilliform drug eruption. https://ja.ma/3QMJemU
JAMA Deputy Editor Mary M. McDermott, MD, and Naomi M. Simon, MD, MSc, professor of the Department of Psychiatry @nyugrossman, discuss diagnosis and treatment of #AnxietyDisorders. https://ja.ma/3C0SpKA
This cross-sectional study of data from Jan 2017 to Dec 2021 found that population-based screening and diagnosis in the US remained below prepandemic levels for breast, cervical and colorectal cancer. https://ja.ma/3wg85Gs
Narrative review of #migraine management in patients with #renal or #hepatic disease
@ChiaChunChiang @BethRobertsonMD et al @MayoClinicNeuro
https://headachejournal.onlinelibrary.wiley.com/doi/full/10.1111/head.14437
Medical News in Brief: Medicaid Expansion Tied to Reduction in Postpartum Hospitalizations https://ja.ma/3DaphRl
A previously healthy 14-year-old boy who lived on a farm presented with a 1-month history of episodic headaches associated with vomiting. What is the most likely diagnosis? https://nej.md/2Ku5WxD
Medical News in Brief: New CT Scan Distinguishes Primary Aldosteronism Subtypes https://ja.ma/3XZnuGK
Perspective: Sources of Innovation in Gene Therapies
https://nej.md/3HvkaOc
Correspondence: Immunogenicity of a Fourth Homologous Dose of NVX-CoV2373
https://nej.md/3XV2FMN
Anybody else listen to Sunday reads through the NYT Daily and prefer the reporter’s read to the professional Audm one?
Induction of labor is a common obstetric intervention. The @WHO global survey 2010 reported an induction rate above 25% in high-income English-speaking countries and 35% in Sri Lanka, with the highest reported induction of labor rate.
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