Cleveland Clinic journal of medicine
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The wide-ranging, multisystemic manifestations of sarcoidosis can make diagnosis and management difficult. Corticosteroid treatment is effective, but the optimal time to start, the dose, and the duration of treatment are controversial. We are just beginning to understand the genetic basis of sarcoidosis.
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Most women with epilepsy today can conceive and bear normal, healthy children, but their pregnancies present an increased risk for complications. Pregnancy can exacerbate seizure frequency in some women with epilepsy, and both maternal epilepsy and in utero exposure to antiepileptic drugs can increase the risk of adverse outcomes in children born to women with epilepsy. These outcomes include fetal loss and perinatal death, congenital malformations and anomalies, neonatal hemorrhage, low birth weight, developmental delay, and childhood epilepsy. After reviewing these risks, this article concludes with practical recommendations for reducing these risks and optimizing the management of pregnant women with epilepsy.
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Review Comparative Study
New fibrinolytic agents for MI: as effective as current agents, but easier to administer.
The efficacy and safety of fibrinolytic agents have not dramatically changed since alteplase (Activase), a derivative of tissue plasminogen activator (t-PA), was introduced nearly 2 decades ago. However, newer agents have a longer half-life, making them easier to deliver. Fibrinolytic therapy is underused in many patients, especially in those traditionally thought to be at high risk for complications.
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The history and physical examination, rather than routine laboratory, cardiovascular, and pulmonary testing, are the most important components of the preoperative evaluation. The history should include a complete review of systems (especially cardiovascular and pulmonary), medication history, allergies, surgical and anesthetic history, and functional status.