Articles Tagged With: management
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Empowered Relief vs. CBT vs. Health Education for Low Back Pain
This randomized clinical trial involving adults with chronic low back pain demonstrates that a single session of a pain management class, when compared to a full course of cognitive behavioral therapy, yields noninferior (clinically on par) outcomes in pain catastrophizing and several other measures at the three-month follow-up.
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Gestational Diabetes Mellitus: An Update on Care
Early detection of gestational diabetes mellitus (GDM) allows for the implementation of appropriate interventions to reduce the adverse effects of uncontrolled hyperglycemia, making GDM screening an integral part of prenatal care. However, the question of whether to adopt universal or selective (risk-based) screening for GDM has been a subject of ongoing debate and lacks a clear international consensus.
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Does Anyone with Severe Aortic Stenosis Not Benefit from TAVR?
A single-center, retrospective study of low-flow low-gradient aortic stenosis patients has shown that a gradient < 20 mmHg identifies a high-risk group because of significant comorbidities that may not benefit from transcutaneous aortic valve replacement.
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Long-Term Follow-Up Confirms Efficacy of Invasive Strategy in Very Old Patients with Non-ST Elevation ACS
In this long-term analysis of patients in the After Eighty Study, with a mean age of 85 years and non-ST-elevation acute coronary syndrome, an invasive strategy showed a reduction in a composite endpoint of major adverse cardiovascular events and was associated with a significant improvement in event-free survival compared with a conservative approach.
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Metformin for the Management of Early Gestational Diabetes
The administration of metformin in the early stages of gestational diabetes did not demonstrate superiority over placebo in relation to the need to start insulin therapy prior to delivery, or on fasting blood glucose concentrations ≥ 5.1 mmol/L at either the 32nd or 38th weeks of gestation (composite primary outcome).
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Chronic Obstructive Pulmonary Disease Update for Primary Care Providers
The Global Initiative for Chronic Obstructive Lung Disease 2023 report defines chronic obstructive pulmonary disease (COPD) as a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, and/or exacerbations) caused by abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that result in persistent, often progressive, airflow obstruction. COPD was the fourth leading cause of death in the United States in 2018 and is estimated to be responsible for 3 million deaths annually around the world, with expected increases to 5.4 million annual deaths from COPD and related conditions by 2060.
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Ovarian Torsion: What Is the Best Surgical Management Strategy?
In this national retrospective cohort study from 2008 to 2020, there were 1,791 surgeries for adnexal torsion, with 30.3% involving ovarian conservation and the remainder undergoing oophorectomy. The proportion of oophorectomies compared to ovarian conservation decreased slightly over the study period (average decrease, -1.6% per year; 95% confidence interval, -3.0%- to -0.22%).
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Surgical Management of Missed and Incomplete Abortion: Is Hysteroscopy Useful?
In this randomized controlled trial of 563 women comparing vacuum aspiration and operative hysteroscopy for incomplete spontaneous abortion, there was no difference in pregnancy rates within the following two years (62.8% hysteroscopy vs. 67.6% vacuum aspiration; risk difference, -4.8%; 95% confidence interval, -13% to 3%).
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U.S. Slips in Blood Pressure Management
After years of improvement in this area, investigators recently observed troubling decline in rate control. -
Management of Heavy Menstrual Bleeding: Levonorgestrel-Releasing Intrauterine System vs. Endometrial Ablation
In this multicenter, randomized, noninferiority trial among patients aged 34 years and older with heavy menstrual bleeding, the levonorgestrel-releasing intrauterine system did not meet the noninferiority threshold when compared to endometrial ablation for mean blood loss at 24 months following intervention. Both interventions did lead to large decreases in blood loss and comparable satisfaction and quality-of-life scores.