Analyses of clinical trials find that an intensive systolic blood pressure (SBP) target of less than 120 mm Hg is cost-effective compared with a target of less than 140 mm Hg for patients at high cardiovascular disease risk. However, guidelines from the American College of Cardiology and American Heart Association recommend a target of less than 130 mm Hg, citing blood pressure measurement error in routine practice.

Optimal transfusion strategies for patients with acute myocardial infarction (AMI) are uncertain. The aim of this guideline is to provide recommendations for red blood cell transfusion in patients with AMI.

Accurate blood pressure measurement (BPM) is essential for managing hypertension, but previous studies have not systematically compared different monitoring methods across varying BP levels. To address this gap, a comprehensive analysis using network meta-analysis (NMA) and meta-regression was done to evaluate their agreement and clinical implications.

The U.S. health care system is experiencing numerous supply chain disruptions, including for important medications. Prescription drug shortages have been at record levels and have affected more drugs in recent years, especially generic sterile injectables and other low-margin medications. These shortages arise from a confluence of factors, including the complexity of the entire production and delivery supply chain, quality issues, outdated manufacturing facilities and practices, drug purchasing policies that prioritize lowest price over reliable production, changes in prescribing and usage patterns, geopolitical constraints, and market concentration, among other factors. When prescription drugs are in shortage, patients face negative health outcomes due to being unable to obtain necessary treatments, the stress associated with securing medications, and adverse effects from alternative treatments. Physicians also face substantial burden in navigating drug shortages because they must expend time and resources in identifying alternative treatment options and obtaining prior authorization for the coverage of alternative drugs, negatively affecting the patient-physician relationship. Policymakers, regulators, manufacturers, health systems, health professionals, and other relevant entities must collaborate to further efforts to ameliorate drug shortages and promote equitable access to treatments. In addition to short-term measures to address the immediate effect of drug shortages, policymakers, manufacturers, and drug purchasers should also undertake efforts to prevent future drug shortages by investing in, strengthening, and diversifying prescription drug supply chains and incentivizing procurement practices that emphasize reliable and sustainable production practices. Such efforts must be undergirded by policies to improve monitoring of and transparency into the prescription drug supply chain.

The growing complexity of cancer care may be driving an increase in subspecialized medical oncologists who focus on treating specific cancer types. However, little is known about trends in subspecialization among oncologists and differences in utilization of subspecialists.

Infective endocarditis is a common and morbid condition involving prolonged hospital stays, significant disability, and a high mortality rate. The current crises of injection drug use and opioid use disorder have contributed to high rates of infective endocarditis in the United States. Endocarditis in patients who inject drugs involves additional management complexity for multiple reasons. Several infective endocarditis management guidelines exist, including from the American Heart Association and the European Society of Cardiology. In light of the unique challenges of caring for this particular population, in 2022 the American Heart Association published a scientific statement specifically focusing on infective endocarditis in people who inject drugs. In these rounds, 2 experts in their respective fields, an infectious diseases specialist and a cardiac surgeon, discuss medical management, interventional approaches, and the value of multidisciplinary care for tricuspid valve endocarditis in a person who uses injection drugs, both in general and in relation to Mr. Y, a 30-year-old man with a history of substance use disorder, methicillin-sensitive Staphylococcus aureus bacteremia, and right-sided endocarditis.

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, with a prevalence of 4% to 10%. It is a chronic condition characterized by abdominal pain in conjunction with altered bowel habits, abdominal distention, or bloating. IBS can present with 3 different defecation patterns: IBS with constipation, IBS with diarrhea, or mixed IBS. Recent advances in IBS include a positive diagnosis based on symptom-based criteria and a treatment plan based on IBS subtype and bothersome symptoms. In addition to diet and lifestyle modifications, this article discusses the role of new pharmacologic and nonpharmacologic treatment options for the management of IBS.

It is unclear whether weight loss before in vitro fertilization (IVF) improves reproductive outcomes in women with obesity.

GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text].

Treatment options for children and adolescents with type 2 diabetes mellitus (T2DM) are limited. Canagliflozin is a sodium-glucose cotransporter-2 inhibitor approved for the treatment of T2DM in adults.

GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text].

GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text].