May 27th, 2022 - Clinical practice guidelines on the management of patent foramen ovale (PFO) from the Society for Cardiovascular Angiography and Interventions (SCAI) were published in May 2022 in  JSCAI.[1] In patients aged 18-60 years who have had a PFO-related stroke, PFO closure is strongly recommended instead of antiplatelet therapy alone. For patients aged 60 years and older with a history of PFO-related ...

May 27th, 2022 - SAN DIEGO, California — Race-based recommendations and clinical algorithms may be doing more harm than good, according to a systematic review of databases and guidelines. The study found examples of screening recommendations based on race or ethnicity that were likely misleading since these are social constructs that don't reflect a patient's individual risk, said Shazia Siddique, MD, who prese...

May 26th, 2022 - Sildenafil (Viagra, Pfizer), a phosphodieterase-5 (PDE-5) inhibitor and a pulmonary-selective vasodilator, may reduce mortality in patients with idiopathic pulmonary fibrosis (IPF), compared with placebo or standard of care but it does not reduce hospitalizations or acute exacerbations from the disorder, a small meta-analysis suggests. "There have only been four trials investigating sildenafil ...

May 24th, 2022 - UPDATED May 26, 2022 // Editor's note: This article has been updated with additional comments. Fidaxomicin (Fificid) emerged favorable to vancomycin for the treatment of both initial and recurrent Clostridioides difficile infections in a Medicare population, according to a new retrospective study. Although fidaxomicin was about 14% more effective than vancomycin in treating the initial infectio...

May 24th, 2022 - Contraceptive counseling and interventions beyond usual care significantly increased the use of contraceptives with no accompanying increase in sexually transmitted infections or reduction in condom use, based on data from a new meta-analysis. “Although effective contraception is available in the United States and guidelines support contraceptive care in clinical practice, providing contracepti...

May 23rd, 2022 - Intravenous thrombolysis (IVT) for acute stroke appears safe for patients who have recently received direct oral anticoagulant (DOAC) therapy, a new observational study suggests, prompting researchers to ask whether guidelines that restrict its use should be updated. Researchers found that DOAC users were significantly less likely to develop symptomatic intracerebral hemorrhage (sICH) after IVT...

May 23rd, 2022 - The American Society of Clinical Oncology (ASCO) has issued a new guideline on exercise, diet, and weight management during active cancer treatment in adults. The main endorsement was for oncology providers to recommend aerobic and resistance exercise to patients who are undergoing active treatment with curative intent, in order to mitigate side effects associated with therapy. Clinicians may a...

May 20th, 2022 - It's "critically important" for clinicians to recognize that not all patients with hypothyroidism are fully treated with levothyroxine (LT4) and some may need combination treatment with triiodothyronine (LT3) despite normal levels of thyroid stimulating hormone (TSH), according to thyroid expert Antonio C. Bianco, MD, PhD. Speaking to a crowded room at the recent American Association of Clinica...

May 20th, 2022 - A new decision tree tool guides anesthesiologists through managing patients with difficult airways by improving communication and identifying factors of concern, according to a report in Anesthesia & Analgesia.    "The American Society of Anesthesiologists (ASA) Task Force on Management of the Difficult Airway has developed a decision tree tool that uses inductive assessments to guide the anest...

May 20th, 2022 - The first-ever guidelines for interventional cardiologists using percutaneous patent foramen ovale closure recommend expanding the use of the procedure beyond the Food and Drug Administration-approved indication following PFO-associated ischemic stroke, adding clarification about the use of PFO with anticoagulation and hedging against abuse and overuse of the procedure, said the chair of the gu...

May 20th, 2022 - Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center. Misinformation about nirmatrelvir/ritonavir (Paxlovid, Pfizer) for treating mild-to-moderate COVID-19 in patients at high risk for severe disease is feeding misunderstanding among prescribers and patients, two experts from the Infectious Diseases Society of America (IDSA) said on Friday. They br...

May 19th, 2022 - The American Urological Association (AUA) 2022 Annual Meeting took place recently at the Ernest N. Morial Convention Center in New Orleans. A common theme among attendees was that although Zoom is a wonderful tool to disseminate information, something about physically attending a conference makes the meeting more rewarding and productive. Hundreds of talks and abstracts were presented over the ...

May 19th, 2022 - Each year, there are about 59,000 deaths from rabies globally. Most of these occur outside the United States and are the result of dog bites. Since infection with rabies is almost always fatal, there has been considerable attention given to vaccinating people at high risk before likely exposure and responding immediately to those bitten by a rabid animal. The Centers for Disease Control and Pre...

May 19th, 2022 - Researchers have created and validated a risk model based on digital breast tomosynthesis (DBT) images that can predict a woman's chance of developing breast cancer within a year of a negative or benign mammography screening exam. This model could potentially lead to earlier detection and improved prognosis. "The DBT risk model is fully automated and provides the clinician with a risk category ...

May 17th, 2022 - Many strategies widely considered "standard care" for managing spontaneous intracerebral hemorrhage (ICH) are not as effective as previously thought and are no longer recommended in updated guidelines from the American Heart Association (AHA)/American Stroke Association (ASA). Compression stockings, antiseizure medication, and steroid treatment are among the treatments with uncertain effectiven...

May 13th, 2022 - All patients with idiopathic inflammatory myopathies (IIM) should be screened for swallowing difficulties, according to the first evidence-based guideline to be produced. The guideline, which has been developed by a working group of the British Society for Rheumatology (BSR), also advises that all diagnosed patients should have their myositis antibody levels checked and have their overall well-...

May 13th, 2022 - The American Society for Radiation Oncology (ASTRO) has issued new guidance on the use of radiation therapy for the treatment of brain metastases, an update on its 2012 document.   "In the decade since the previous ASTRO brain metastases guideline, there has been a tremendous evolution in the way we manage patients' disease," said Paul D. Brown, MD, chair of the guideline task force and a profe...

May 13th, 2022 - New clinical practice guidelines for the diagnosis and management of nonalcoholic fatty liver disease (NAFLD) are the first to be targeted specifically to primary care and endocrinology clinical settings. They include 34 evidence-based clinical practice recommendations for screening, diagnosis, management, and referral, presented in a table and an algorithm flow chart as well as detailed text. ...

May 13th, 2022 - Researchers published the study covered in this summary on researchsquare.com as a preprint that has not yet been peer reviewed. Key Takeaways The results suggested that early prolonged hormonal therapy is advisable in all patients with cryptorchidism to increase the speed of testicular descent to the scrotum achieved by surgery, and thereby maintain adequate sperm quality in adulthood. Why Thi...

May 12th, 2022 - Idiopathic pulmonary fibrosis (IPF) is the most common interstitial lung disease. Although the cause of IPF is unknown, factors thought to increase an individual's risk of developing IPF include a history of smoking, gastroesophageal reflux disease, environmental exposures, and genetic predispositions. Patients with IPF present with fatigue, dry cough, and progressive respiratory distress of mo...