Articles Tagged With: therapy
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Clinical and Perfusion Mismatch Criteria Both Are Reliable in Identifying Patients Who Will Benefit from Endovascular Therapy
Since 2015, when multiple clinical trials were published showing the efficacy of endovascular thrombectomy (EVT) for large vessel occlusion within six hours of stroke onset, additional criteria have been developed to identify those patients who will benefit from EVT beyond six hours. The AURORA investigators collected patient data from six large clinical trials and performed a meta-analysis to determine if a clinical mismatch or an imaging mismatch protocol was better at predicting good outcomes in patients treated between six hours and 24 hours after the onset of clinical stroke symptoms.
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Basilar Artery Occlusion: Endovascular Thrombectomy and Medical Therapy Have Similar Outcomes
Basilar artery occlusion is a rare form of ischemic stroke and accounts for about 10% of large vessel occlusions reported in the literature. These investigators conducted a randomized trial, enrolling patients from 2011 through 2019, even though multiple studies published in 2015 demonstrated benefit of endovascular therapy in anterior circulation large vessel occlusions. Efficacy and safety were compared with medical therapy in patients who underwent endovascular therapy within six hours after the estimated time of onset of symptoms.
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Recognizing Personality Disorders in Patients Presenting to the Primary Care Provider
Often not well understood by the medical community and surrounded in stigma, patients with personality disorders frequently are labeled difficult. Understanding that the behaviors responsible for this label may be the result of a personality disorder allows the provider to adopt a more nuanced approach to treatment.
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HIV Management During Pregnancy
Human immunodeficiency virus (HIV) infection during pregnancy carries a significant burden to healthcare systems, and continues to be of significant public health concern.
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Employing Technology and Exergames to Improve Balance Post-Stroke
This small pilot study reveals potential for exergames (activity-based video games) to be used as a telemedicine rehabilitation intervention in improving balance and function in patients six to eight weeks post-stroke.
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Tenecteplase vs. Alteplase for Thrombolysis in Basilar Artery Occlusion
Basilar artery occlusion is a dangerous clinical syndrome of large artery occlusion that carries a high morbidity and mortality with severe disability in survivors. In multiple trials, alteplase has shown minimal benefit in achieving reperfusion in patients with large artery occlusion, including the basilar artery. Tenecteplase is a modified variant of alteplase that has greater specificity in binding to fibrin, a longer half-life, and can be administered in a single bolus.
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Pharmacological Therapies in HFrEF: Is Quadruple Therapy a New Standard of Care?
Approximately 50% of patients with heart failure have heart failure with reduced ejection fraction (HFrEF). HFrEF morbidity and mortality are altered favorably with the use of guideline-directed medical therapy. Multiple drug therapies have informed evidence-based therapies for the treatment of HFrEF.
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Does the Addition of IV Metronidazole Improve Outcomes of Severe Clostridioides difficile Infection?
These studies indicate that the addition of intravenously administered metronidazole in the treatment of severe Clostridioides difficile infection is unwarranted.
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Elevated Procalcitonin Is Associated with Increased Mortality in Pulmonary Tuberculosis
A single-center, prospective, observational study found that an elevated procalcitonin level was associated with an increased risk of death in patients with pulmonary tuberculosis.
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Convalescent Plasma Therapy Does Not Affect Time to Clinical Improvement in Patients with Severe and Life-Threatening COVID-19
This was a randomized, open-label, multicenter trial of intravenous convalescent plasma infusion (4 mL/kg to 13 mL/kg) therapy. Convalescent plasma therapy was not associated with improvements in mortality or time to clinical improvement.