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Recent Submissions
Integrating Artificial Intelligence Support in Patient Care While Respecting Ethical Principles.
Sharko, M.; Cole, C.L. (American Medical Association, 2025-03-03)
Body weight reduction in women treated with tirzepatide by reproductive stage: a post hoc analysis from the SURMOUNT program.
Tchang, B.G.; Mihai, A.C.; Stefanski, A.; García-Pérez, L.E.; Mojdami, D.; Jouravskaya, I.; Gurbuz, S.; Taylor, R.; Karanikas, C.A.; Dunn, J.P. (Wiley, 2025-03-12)
OBJECTIVE: Increases in adiposity and adverse changes in adipose distribution commonly occur in women during midlife and with the onset of menopause. This post hoc analysis assessed body weight changes with tirzepatide by reproductive stage. METHODS: Women participants from SURMOUNT-1, -3, and -4 randomized to tirzepatide (15 mg or maximum tolerated dose) or placebo were retrospectively categorized as being in the pre-, peri-, or post-menopause stages. Body weight and waist circumference changes, the proportion of participants achieving body weight-reduction thresholds, and waist to height ratio (WHtR) category shift among those with baseline BMI < 35 kg/m2 were assessed at end of study treatment. RESULTS: In SURMOUNT-1, significantly greater body weight reductions from baseline were observed with tirzepatide versus placebo in women in the premenopause (26% vs. 2%), perimenopause (23% vs. 3%), and postmenopause stages (23% vs. 3%; p < 0.001). Greater waist circumference reductions were also observed with tirzepatide across the subgroups (22 vs. 4 cm, 20 vs. 5 cm, and 20 vs. 4 cm, respectively; p < 0.001). Across the reproductive stage subgroups, 97% to 98% of participants achieved body weight reductions that were ≥5% with tirzepatide versus 29% to 33% with placebo. Furthermore, 30% to 52% of women among the reproductive stage subgroups who had baseline BMI < 35 kg/m2 reached WHtR ≤ 0.49 (low central adiposity) with tirzepatide. Similar results were observed in SURMOUNT-3 and -4. CONCLUSIONS: In this post hoc analysis, tirzepatide treatment was associated with significant body weight, waist circumference, and WHtR reductions versus placebo in women living with obesity or overweight and without type 2 diabetes, irrespective of reproductive stage.
A Pilot Trial Evaluating Collaborative Healthcare Encounters With Caregivers: A Checklist-Based Intervention for Primary Care.
Riffin, C.; Brody, L.; Wolff, J.L.; Pillemer, K.A. (SAGE Publications, 2025-02-27)
This pilot trial aimed to evaluate the feasibility, acceptability, and preliminary efficacy of Collaborative Healthcare Encounters with Caregivers (CHEC), a checklist-based intervention designed to enhance caregiver participation in older adults' primary care visits. N = 52 older patient-caregiver dyads were randomized to CHEC (n = 28) or usual care (n = 24). Visits were audio-recorded and analyzed according to a standardized coding procedure. Post-visit questionnaires assessed caregivers' perceptions of the checklist, efficacy in primary care interactions and knowledge of relevant resources. CHEC caregivers perceived the checklist to be useful and easy to complete. Visit duration was comparable in CHEC and usual care visits (M = 31.4 minutes vs. M = 31.8 minutes; p = .55), but CHEC visits allocated a greater proportion of time to discussing caregivers' concerns about the patient (32.9% vs. 18.9%; p = .04). CHEC caregivers reported slightly higher post-visit self-efficacy and significantly greater knowledge of relevant resources. Findings suggest CHEC's potential as a clinically feasible intervention for primary care. Clinical Trials Identifier: NCT04946942.
The Significance of Premature Ventricular Contractions in the Normal Heart.
Raizada, A.; Parikh, M.A.; Mihatov, N.; Frishman, W.H.; Peterson, S.J. (Lippincott, Williams & Wilkins, 2025-03-10)
The incidence of premature ventricular contractions (PVCs) in a structurally normal heart can result in clinically significant consequences, including PVC-induced cardiomyopathy. It is essential to consider the electrophysiologic characteristics of the PVCs to determine the patient's susceptibility. In an asymptomatic patient with no other structural heart disease and with PVCs, it is crucial to understand both the prognostic significance of the PVCs and when to initiate treatment with the appropriate modality. This review aims to review the clinical significance of PVCs in a normal heart and discuss the appropriate timing of treatment and first-line therapy.
Renal Denervation: A New Therapy for Resistant Hypertension.
Trivedi, D.B.; Parikh, M.A.; Turitto, G.; Frishman, W.H.; Peterson, S.J. (Lippincott, Williams & Wilkins, 2025-02-27)
The Food and Drug Administration (FDA) recently approved renal denervation to treat resistant hypertension. This procedure is a minimally invasive procedure that starts by placing a catheter in the renal artery. This catheter is used to send either radiofrequency heat or ultrasound waves to burn the superficial nerves surrounding the renal arteries while making certain no damage happens to the renal arteries themselves. This procedure is done after a renal angiogram to ensure patency of the renal artery. Each radiofrequency ablation will take 1-2 minutes, depending on the device used. The radiofrequency balloon generator requires one single application of the radiofrequency pulse. The radiofrequency generator that uses a catheter tube will need more than one pulse. The second approved option uses ultrasound to generate an electrical signal that is converted into ultrasound vibration, that occurs at the distal end of the catheter. This vibration heats the system around the nerves, disrupting the superficial nerves that communicate with the central nervous system. This will result in lowering the blood pressure. We will review the studies that led to FDA approval, and the current guidelines for use. The FDA now approves both devices.