Atrial fibrillation has a lifetime prevalence of 15% to 40% and predisposes patients to stroke and cardiac dysfunction. This JAMA Clinical Guidelines Synopsis focuses on recommendations for long-term management of AF, including new paradigms for rhythm control and stroke risk reduction.
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Dialysis for Chronic Kidney Failure: A Review
Importance: More than 3.5 million people worldwide and 540 000 individuals in the US receive maintenance hemodialysis or peritoneal dialysis for the treatment of chronic kidney failure. The 5-year survival rate is approximately 40% after initiation of maintenance dialysis.
Observations:...
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Calcific Aortic Stenosis: A Review
Importance: Calcific aortic stenosis (AS) restricts the aortic valve opening during systole due to calcification and fibrosis of either a congenital bicuspid or a normal trileaflet aortic valve. In the US, AS affects 1% to 2% of adults older than 65 years and approximately 12% of adults older...
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The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update
The American Society of Addiction Medicine (ASAM) developed this National Practice Guideline for the Treatment of Opioid Use Disorder to provide information on evidence-based treatment of opioid use disorder. This guideline is an update and replacement of the 2015 ASAM National Practice...
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Prolonged Grief Disorder
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations.
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Diagnosis and management of depression in adolescents
KEY POINTS
Depression is common among adolescents in Canada and has the potential to negatively affect long-term function and quality of life; despite this, in most affected adolescents depression remains undetected and untreated.
Management requires a multimodal approach, including...
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Seasonal Affective Disorder
This fact sheet provides information about seasonal affective disorder (SAD), a type of depression. It includes a description of SAD, signs and symptoms, how SAD is diagnosed, causes, and treatment options.
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Ovarian Aging and Fertility
Women in their late 30s to early 40s who have difficulty conceiving are often unaware that success rates of fertility treatment decline with age, most commonly due to declining ovarian function. Counseling about the high prevalence of infertility and miscarriage may be met with surprise and...
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Vitamin K2 in Managing Nocturnal Leg Cramps: A Randomized Clinical Trial
Importance: Currently, there are no treatments for nocturnal leg cramps (NLCs) that have been proven to be both safe and effective. Seeking safe and effective approaches for managing NLCs is of crucial importance.
Objective: To determine whether vitamin K2 is better than placebo in...
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Prevention, Diagnosis, and Treatment of Acute Altitude Illness
People traveling to high altitude are at risk of developing acute altitude illnesses, including AMS, HACE, and HAPE. Incidence and risk are assessed by history of acute altitude illness, sleeping elevation above sea level on day 1 of travel, and rate of ascent. AMS incidence can range from...
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