altepase

The EXTEND trial: neurological deficits decreased with thrombolysis up to 9 hours after stroke onset

1. Patients presenting between 4.5 and 9 hours after stroke onset with viable brain tissue who received thrombolytic therapy had better neurological outcomes compared to those receiving placebo. 2. Symptomatic intracranial hemorrhage occurred in a higher number of patients in the thrombolysis group compared to placebo group. Evidence Rating Level: Czytaj więcej…

bleeding during pregnancy

The PRISM trial: Progesterone therapy does not alter birth outcomes in women with early pregnancy bleeding

1. Women with early pregnancy bleeding administered progesterone experienced similar rates of live births occurring after 34 weeks’ gestation as women treated with placebo. 2. Subgroup analysis was generally inconclusive, though many subgroups had risk ratios approaching significance supporting progesterone use. Evidence Rating Level: 1 (Excellent)   Study Rundown: Miscarriages are Czytaj więcej…

cholecystectomy

Quick Take: Restrictive strategy versus usual care for cholecystectomy in patients with gallstones and abdominal pain (SECURE)

Laparoscopic cholecystectomy for the treatment of symptomatic cholecystolithiasis is currently the standard of care. However, multiple studies indicate that 10-41% of patients continue to have symptoms despite cholecystectomy. This finding warrants investigation of alternative strategies in the treatment of symptomatic gallstone disease. In this randomized controlled non-inferiority trial, 1,067 patients Czytaj więcej…

Cardiology

Quick Take: Association of Rivaroxaban With Thromboembolic Events in Patients With Heart Failure, Coronary Disease, and Sinus Rhythm

Rivaroxaban is a selective direct factor Xa inhibitor that has been associated with improved outcomes in stable patients with chronic atherosclerotic cardiovascular disease and acute coronary syndrome. Nevertheless, its role in the treatment of patients with coronary artery disease (CAD) in addition to heart failure remains unclear. In the COMMANDER Czytaj więcej…

benzodiazepine

Quick Take: Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT)

Convulsive status epilepticus (SE) is the most common life-threatening neurological emergency in pediatrics. It is associated with significant morbidity and mortality, with 22% of patients ultimately requiring intubation and intensive care unit admission. Benzodiazepines are used first-line in terminating seizure activity. However, when this fails, phenytoin is the current standard Czytaj więcej…