Intravenous thrombolysis beyond the standard 4.5-hour window can be considered in select patients with acute ischemic stroke, primarily those with evidence of salvageable brain tissue on advanced imaging, wake-up or unknown-onset stroke with favorable MRI profiles, and... |
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Thoracentesis can alleviate respiratory symptoms by reducing diaphragm distortion, improving diaphragmatic function, and decreasing respiratory drive. However, the recent TAP-IT randomized controlled trial showed that routine thoracentesis does not offer significant... |
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Routine initiation of levothyroxine is not recommended in euthyroid pregnant women with positive TPO antibodies. This is supported by high-quality RCTs showing no significant improvement in pregnancy outcomes, as well as by major international guidelines... |
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In patients with suspected acute bacterial meningitis, specific clinical features necessitate neuroimaging prior to lumbar puncture to prevent serious complications such as cerebral herniation. These features include significantly altered mental status (GCS ≤ 10), focal... |
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For patients with dysmenorrhea not responding to NSAIDs, a stepwise, evidence-based approach is recommended: confirm adherence and rule out secondary causes, offer hormonal therapy (CHCs, progestins, LNG-IUS), incorporate nonpharmacologic and complementary... |
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Based on current evidence and guidelines, the medications with the most favorable safety profiles for pediatric obesity management are GLP-1 receptor agonists, phentermine-topiramate combination, and metformin. Conversely, orlistat is not recommended due to its... |
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A 24-week pregnant patient initially presented with symptoms of sinusitis that had been present for only 1 day and did not meet diagnostic criteria for ABRS at the time. Despite this, she was started on ceftriaxone. On day 5 of symptoms, she returns with persistent fever... |
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