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AI-enabled ultrasound devices are able to accurately estimate gestational age (GA) between 14 and 27 weeks when employed by novice users. This is particularly of importance in resource poor settings.

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A single center retrospective treatment of 144 patients who tested positive for C. trachomatis found that 18% (n=26) of patients did not pick up their prescription for doxycycline. Those who did not obtain their doxycycline prescription were 3 times more likely to return to the ED within 28 days for the same chief complaint.

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Doxycycline adherence for the management of Chlamydia trachomatis infections. Am J Emerg Med. 2024;81:136-139. doi:10.1016/j.ajem.2024.05.003. PMID: 38728936.

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Treponema pallidum, the bacteria that cause syphilis, has nearly universal (99.2%) resistance to azithromycin. Use penicillin in these patients.

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Near-Universal Resistance to Macrolides of Treponema pallidum in North America. N Engl J Med. 2024 Jun 13;390(22):2127-2128. doi: 10.1056/NEJMc2314441. PMID: 38865666

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Although infrequent, precipitous vaginal deliveries in the ED occur and are associated with higher rates of maternal and fetal complications. Here's how you can be prepared to manage these deliveries and common complications.

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This Danish nationwide cohort study found that in reproductive-age women, NSAID use alone increased the risk of venous thromboembolism (VTE). The magnitude of risk was compounded by concomitant use of hormonal contraception.

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Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs: nationwide cohort study. BMJ 2023; 382 :e074450 doi:10.1136/bmj-2022-074450.

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Vaginal swabs are more accurate than urine samples in diagnosing Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. These results support CDC recommendations that vaginal swabs are the preferred sample modality when testing for STIs in women.

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Vaginal Swab vs Urine for Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis: A Meta-Analysis. Ann Fam Med. 2023 Mar-Apr;21(2):172-179. doi: 10.1370/afm.2942.

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Pregnant patients who present with signs and symptoms concerning for PE can be safely evaluated using Wells criteria or the YEARS algorithm. 

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Noninvasive diagnostic work-up for suspected acute pulmonary embolism during pregnancy: a systematic review and meta-analysis of individual patient data. J Thromb Haemost. 2023 Mar;21(3):606-615. doi: 10.1016/j.jtha.2022.11.025. Epub 2022 Dec 22.

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Though incremental progress has occurred over the last several decades, inequities loom for people that wish to become pregnant during medical training.

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Pregnancy and Residency - Overdue for Equity. N Engl J Med. 2023 Mar 16;388(11):966-967. doi: 10.1056/NEJMp2215288. Epub 2023 Mar 11.

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The primary survey and standard initial interventions are the same. Here is how a viable pregnancy changes the algorithm beyond that.  

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Ovarian torsion is a rare condition that is difficult to diagnose and associated with significant morbidity. Key points are summarized here, but reading the entire article is highly recommended. It's short and packed with important information.

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High risk and low prevalence diseases: Ovarian torsion. Am J Emerg Med. 2022 Mar 31;56:145-150. doi: 10.1016/j.ajem.2022.03.046. Online ahead of print.