Articles: treatment.
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Comparative Study Observational Study
Conservative Versus Operative Treatment of Proximal Humerus Fractures in Older Individuals—an Analysis of Insurance Data.
Little is known about the frequency and results of conservative treatment of proximal humerus fractures (PHF) in older individuals. ⋯ The conservative treatment of PHF is associated with a lower overall rate of complications due to surgery or trauma, but also with more MAE, more TE, and higher mortality. These findings underline the need for individualized and risk-adjusted treatment recommendations.
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Practice Guideline
Clinical Practice Guideline: Microhematuria in Children and Young Adults—Evaluation for the Early Detection of Kidney Disease.
Occult blood in the urine, or microhematuria, is a common finding (about 10%) in children and young adults. It is often of brief duration and therefore harmless. In persistent microhematuria, acanthocytes in the urine are a frequently unrecognized early marker of glomerular kidney disease. The purpose of this guideline is to promote the early detection of kidney disease in children and young adults with practical, evidence-based recommendations. ⋯ In the absence of a guideline until now, findings have often been incorrectly assessed, leading either to an inadequate work-up or to excessive diagnostics. As a result, in approximately 30% of young patients, valuable opportunities for early treatment to protect the kidneys have been missed.
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Psoriasis was long regarded as an inflammatory disease limited to the skin. Data from dermatologic, rheumatologic and cardiologic research now show it to be a systemic disease, for which the term psoriatic disease is used. ⋯ In view of the complexity of psoriatic disease, structured management is now recommended so that physicians and patients can work together to determine the optimal treatment strategy.
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Randomized Controlled Trial Multicenter Study
Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes.
Patients with type 2 diabetes and chronic kidney disease are at high risk for kidney failure, cardiovascular events, and death. Whether treatment with semaglutide would mitigate these risks is unknown. ⋯ Semaglutide reduced the risk of clinically important kidney outcomes and death from cardiovascular causes in patients with type 2 diabetes and chronic kidney disease. (Funded by Novo Nordisk; FLOW ClinicalTrials.gov number, NCT03819153.).
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Randomized Controlled Trial Multicenter Study Comparative Study
Bulevirtide Combined with Pegylated Interferon for Chronic Hepatitis D.
In a phase 3 trial, bulevirtide monotherapy led to a virologic response in patients with chronic hepatitis D. Pegylated interferon (peginterferon) alfa-2a is recommended by guidelines as an off-label treatment for this disease. The role of combination therapy with bulevirtide and peginterferon alfa-2a, particularly with regard to finite treatment, is unclear. ⋯ The combination of 10-mg bulevirtide plus peginterferon alfa-2a was superior to bulevirtide monotherapy with regard to an undetectable HDV RNA level at 24 weeks after the end of treatment. (Funded by Gilead Sciences; MYR 204 ClinicalTrials.gov number, NCT03852433.).