Optimal Recovery Following Pediatric Concussion
In this cohort study of children ages 8 to 16 years, including 633 children with concussion and 334 children with orthopedic injury, children with concussion had lower optimal functioning and females were less likely to show optimal functioning than males up to 6 months after injury. These findings suggest that attaining optimal functioning may take 3 months or more after pediatric concussion when multiple domains of outcome are taken into account, especially for girls. Full Access: JAMA
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Incidence and Factors Associated with Recurrent Pericarditis in Lupus
In this cohort study of patients with a history of pericarditis, 20.3% of patients experienced recurrence, among whom most patients (50.8%) experienced only 1 recurrence. In multivariable analysis, factors associated with recurrence included younger age, treatment with oral prednisone, active SLE disease, and time since the initial episode. This study found that recurrence of pericarditis was more likely to occur within the first year since the initial diagnosis of pericarditis, among younger patients, and among those with severe SLE; additionally, findings suggest that oral prednisone therapy should be avoided when treating pericarditis given its association with recurrence. Full Access: JAMA
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Efficacy and Tolerability of Low-Dose Versus High-Dose Doxycycline in the Management of Lymphocytic Scarring Alopecia
In this retrospective review that included 241 adults. The researchers found that high-dose doxycycline was associated with significantly higher rates of adverse effects, most commonly gastrointestinal symptoms and photosensitivity/rash. This study highlights the benefits of low-dose doxycycline, showing comparable efficacy and improved tolerability relative to high doses. Full Access: Journal of the American Academy of Dermatology
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Treatment of Chlamydia and Gonorrhea in Primary Care and Its Patient-Level Variation: An American Family Cohort Study
Chlamydia and gonorrhea are the 2 most common bacterial sexually transmitted infections in the United States. In this study, 6,678 cases of chlamydia confirmed by a positive test and 2,206 cases of gonorrhea confirmed by a positive test were identified; 75.3% and 69.6% of these cases, respectively, were treated. Chlamydia was infrequently treated with the recommended antibiotic, doxycycline (14.0% of cases), and gonorrhea was infrequently treated with the recommended antibiotic, ceftriaxone (38.7% of cases). Guideline adherence remains suboptimal for chlamydia and gonorrhea treatment across primary care practices. Efforts are needed to develop interventions to improve quality of care for these sexually transmitted infections. Full Access: Annals of Family Medicine
