The Journal of family practice
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Review Meta Analysis
Should antenatal testing be performed in patients with a pre-pregnancy BMI ≥ 35?
Possibly. Elevated BMI is associated with an increased risk for stillbirth (strength of recommendation [SOR], B; cohort studies and meta-analysis of cohort studies). Three studies found an association between elevated BMI and stillbirth and one did not. However, no studies demonstrate that antenatal testing in pregnant people with higher BMIs decreases stillbirth rates, or that no harm is caused by unnecessary testing or resultant interventions.
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Here is how to reduce risk factors that can lead to pulmonary hypertension; play a pivotal role in diagnosis; and know when disease requires a referral.
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Type 2 diabetes is a progressive condition with a complex pathophysiology. Over time, additional therapies are needed to maintain glycemic control. It is well known that, by the time of diagnosis, beta cell function has already declined by 50% to 80%. ⋯ In this roundtable discussion, the authors review how people living with type 2 diabetes and their healthcare providers view the initiation of insulin. Other topics include the benefits of longer-acting basal insulin analogs compared with long-acting analogs. The authors emphasize the importance of early and positive conversations about insulin therapy, as well as the benefits of shared decision-making and the use of the wider medical team for the timely initiation of basal insulin therapy.
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Zeroing in on the right drug regimen requires a look at an agent's clinical benefits, tolerability profile, and risk of drug interactions, as well as the patient's comorbidities.
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Compared with provider-administered depot medroxyprogesterone acetate, a prefilled formulation may offer patients improved access to effective contraception.