Annals of internal medicine
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Randomized Controlled Trial Multicenter Study
Total Ankle Replacement Versus Arthrodesis for End-Stage Ankle Osteoarthritis : A Randomized Controlled Trial.
End-stage ankle osteoarthritis causes severe pain and disability. There are no randomized trials comparing the 2 main surgical treatments: total ankle replacement (TAR) and ankle fusion (AF). ⋯ National Institute for Health and Care Research Heath Technology Assessment Programme.
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Comment Meta Analysis
In CV disease, clopidogrel reduces nonfatal MI and MACE vs. aspirin but not stroke or mortality.
Tasoudis PT, Kyriakoulis IG, Sagris D, et al. Clopidogrel monotherapy versus aspirin monotherapy in patients with established cardiovascular disease: systematic review and meta-analysis. Thromb Haemost. 2022;122:1879-87. 35577054.
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Accurately identifying high-need, high-cost (HNHC) patients to reduce their preventable or modifiable health care use for their chronic conditions is a priority and a challenge for U.S. policymakers, health care delivery systems, and payers. ⋯ Agency for Healthcare Research and Quality. (PROSPERO: CRD42020161179).
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Comment Meta Analysis
BP-lowering drugs reduced major CV events by similar amounts in patients with and without type 2 diabetes.
Nazarzadeh M, Bidel Z, Canoy D, et al. Blood pressure-lowering treatment for prevention of major cardiovascular diseases in people with and without type 2 diabetes: an individual participant-level data meta-analysis. Lancet Diabetes Endocrinol. 2022;10:645-54. 35878651.
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Monoclonal gammopathy of undetermined significance (MGUS) is of considerable clinical importance to primary care physicians given its high prevalence in the general population. MGUS has a variable but lifelong risk for progression to hematologic cancer, such as multiple myeloma, Waldenström macroglobulinemia, or light-chain amyloidosis. In addition, MGUS has been associated with several nonmalignant yet symptomatic disorders that require therapy directed toward eliminating the monoclonal gammopathy. Thus, it is important not only to understand the essentials of diagnosing and monitoring patients with MGUS but also to recognize when to refer patients with MGUS to a specialist.