7621. Low-molecular-weight heparin for women with unexplained recurrent pregnancy loss: a multicenter trial with a minimization randomization scheme.
作者: Ekkehard Schleussner.;Gabriele Kamin.;Gregor Seliger.;Nina Rogenhofer.;Susanne Ebner.;Bettina Toth.;Michael Schenk.;Melanie Henes.;Michael K Bohlmann.;Thorsten Fischer.;Oana Brosteanu.;Rupert Bauersachs.;David Petroff.; .
来源: Ann Intern Med. 2015年162卷9期601-9页
A daily injection of low-molecular-weight heparin (LMWH) is often prescribed to women with unexplained recurrent pregnancy loss (RPL), although evidence suggesting a benefit is questionable.
7623. The Ann Arbor Criteria for Appropriate Urinary Catheter Use in Hospitalized Medical Patients: Results Obtained by Using the RAND/UCLA Appropriateness Method.
作者: Jennifer Meddings.;Sanjay Saint.;Karen E Fowler.;Elissa Gaies.;Andrew Hickner.;Sarah L Krein.;Steven J Bernstein.
来源: Ann Intern Med. 2015年162卷9 Suppl期S1-34页
Interventions to reduce urinary catheter use involve lists of "appropriate" indications developed from limited evidence without substantial multidisciplinary input. Implementing these lists, however, is challenging given broad interpretation of indications, such as "critical illness." To refine criteria for appropriate catheter use-defined as use in which benefits outweigh risks-the RAND/UCLA Appropriateness Method was applied. After reviewing the literature, a 15-member multidisciplinary panel of physicians, nurses, and specialists in infection prevention rated scenarios for catheter use as appropriate, inappropriate, or of uncertain appropriateness by using a standardized, multiround rating process. The appropriateness of Foley catheters, intermittent straight catheters (ISCs), and external condom catheters for hospitalized adults on medical services was assessed in 299 scenarios, including urinary retention, incontinence, wounds, urine volume measurement, urine sample collection, and comfort. The scenarios included patient-specific issues, such as difficulty turning and catheter placement challenges. The panel rated 105 Foley scenarios (43 appropriate, 48 inappropriate, 14 uncertain), 97 ISC scenarios (15 appropriate, 66 inappropriate, 16 uncertain), and 97 external catheter scenarios (30 appropriate, 51 inappropriate, 16 uncertain). The refined criteria clarify that Foley catheters are appropriate for measuring and collecting urine only when fluid status or urine cannot be assessed by other means; specify that patients in the intensive care unit (ICU) need specific medical indications for catheters because ICU location alone is not an appropriate indication; and recognize that Foley and external catheters may be pragmatically appropriate to manage urinary incontinence in select patients. These new appropriateness criteria can inform large-scale collaborative and bedside efforts to reduce inappropriate urinary catheter use.
7625. Cervical Cancer Screening in Average-Risk Women: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians.
作者: George F Sawaya.;Shalini Kulasingam.;Thomas D Denberg.;Amir Qaseem.; .
来源: Ann Intern Med. 2015年162卷12期851-9页
The purpose of this best practice advice article is to describe the indications for screening for cervical cancer in asymptomatic, average-risk women aged 21 years or older.
7635. Global Tuberculosis Control: Toward the 2015 Targets and Beyond.
Since 1990, progress has been made toward global tuberculosis (TB) control, as measured by targets set for 2015. However, TB remains a major threat to health around the world. In 2013, there were an estimated 11 million prevalent cases, and an estimated 9.0 million incident cases occurred globally. Approximately 1.5 million deaths were caused by TB, including 360,000 among people living with HIV. Substantial challenges threaten future control efforts. These include multidrug-resistant forms and co-infection with HIV, as well as other factors, such as the increased prominence of noncommunicable diseases and adverse socioeconomic conditions. Beyond 2015, TB control must be seen as both a public health imperative unto itself and a vital component of economic development plans. To that end, control strategies should exploit technical and operational innovations to improve TB control and care and should promote universal health coverage and social protection mechanisms to expand access to essential prevention, diagnostics, and treatment services while avoiding catastrophic costs incurred by patients.
7637. Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia: A Systematic Review and Meta-analysis.
作者: Eliano Pio Navarese.;Michalina Kolodziejczak.;Volker Schulze.;Paul A Gurbel.;Udaya Tantry.;Yingfeng Lin.;Maximilian Brockmeyer.;David E Kandzari.;Julia M Kubica.;Ralph B D'Agostino.;Jacek Kubica.;Massimo Volpe.;Stefan Agewall.;Dean J Kereiakes.;Malte Kelm.
来源: Ann Intern Med. 2015年163卷1期40-51页
Guidelines recommend statins as first-line therapy for dyslipidemia. Monoclonal antibodies targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new lipid-lowering approach.
7638. Grazoprevir-Elbasvir Combination Therapy for Treatment-Naive Cirrhotic and Noncirrhotic Patients With Chronic Hepatitis C Virus Genotype 1, 4, or 6 Infection: A Randomized Trial.
作者: Stefan Zeuzem.;Reem Ghalib.;K Rajender Reddy.;Paul J Pockros.;Ziv Ben Ari.;Yue Zhao.;Deborah D Brown.;Shuyan Wan.;Mark J DiNubile.;Bach-Yen Nguyen.;Michael N Robertson.;Janice Wahl.;Eliav Barr.;Joan R Butterton.
来源: Ann Intern Med. 2015年163卷1期1-13页
Novel interferon- and ribavirin-free regimens are needed to treat hepatitis C virus (HCV) infection.
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