82. Alcohol Use Disorder Treatment Initiation Among U.S. Adult Cancer Survivors With Commercial Insurance: A Cohort Study.
作者: Anton L V Avanceña.;Jyun-Heng Lai.;Corwin M Zigler.;Mary M Velasquez.;Christopher R Frei.;Michael Pignone.
来源: Ann Intern Med. 2025年 91. Moderate- to Long-Term Effect of Dietary Interventions for Depression and Anxiety : A Systematic Review and Meta-analysis.
作者: Eman Abukmail.;Neeraj Koloth Pradeep.;Samantha Ahmed.;Loai Albarqouni.
来源: Ann Intern Med. 2025年
Dietary interventions are a potential alternative treatment of depression and anxiety.
95. Medical, Societal, and Ethical Considerations for Directed Blood Donation in 2025.
作者: Jeremy W Jacobs.;Garrett S Booth.;Mithya Lewis-Newby.;Nabiha H Saifee.;Eamonn Ferguson.;Claudia S Cohn.;Meghan Delaney.;Sarah Morley.;Stephen Thomas.;Rachel Thorpe.;Sheharyar Raza.;Meaghann S Weaver.;Jennifer S Woo.;Deva Sharma.;Cynthia So-Osman.;Nalan Yurtsever.;Christopher A Tormey.;Allison Waters.;Mindy Goldman.;Matthew T S Yan.;Ross M Fasano.;Laura D Stephens.;Elizabeth S Allen.;Christian Erikstrup.;Laura Infanti.;Timothy D Schlafer.;Matthew A Warner.;Jeffrey L Winters.;Aaron A R Tobian.;Evan M Bloch.
来源: Ann Intern Med. 2025年
In the United States and other high-income countries, blood donation primarily relies on anonymous, voluntary donors. However, directed blood donation-where people donate for a specific recipient-has resurged, particularly due to misinformation surrounding COVID-19 vaccination. Requests for "nonvaccinated" blood, driven by misconceptions about vaccine safety, have led to legislative attempts to mandate compliance. Historically, directed donation was used to mitigate the risk for transfusion-related infections before modern screening techniques rendered it largely unnecessary. Today, it presents important patient safety risks, including increased infectious disease transmission, immunologic complications, and logistic burdens. Directed donations also introduce inefficiencies, diverting resources from the community blood supply and exacerbating shortages. Moreover, directed donation for nonmedical indications lacks scientific justification. Blood safety is ensured through rigorous donor screening, pathogen testing, and processing measures. There is no evidence that blood from vaccinated donors poses risk. Requests for nonvaccinated blood, as well as other directed donation preferences based on personal beliefs, introduce biases that are not grounded in medical necessity. Accommodating such requests undermines public trust in blood safety protocols and legitimizes unfounded fears. Ethical concerns arise as non-medically justified requests reinforce discriminatory practices, such as selecting donors based on race or gender. Allowing such preferences risks politicizing blood donation, spreading misinformation, and straining health care systems. Although autonomy is a core ethical principle in medicine, it does not justify non-evidence-based interventions. Given the potential harm and societal impact, directed blood donations should be limited to rare, medically necessary cases. Ongoing legislative efforts to mandate these requests require unified opposition from the medical and scientific community to uphold ethical, evidence-based, blood allocation practices.
98. Lyme Disease.
Lyme disease, caused by Borrelia burgdorferi, is the most common vector-borne disease in the United States, and the range of its tick vector continues to expand. Most Lyme disease cases are diagnosed with the onset of the erythema migrans rashes, which can be single or multiple and vary from a homogeneous erythema to bull's-eye patterns. Serologic antibody testing is of low sensitivity at onset but becomes highly sensitive after a few weeks. Early dissemination may lead to neurologic and cardiac complications. Mono- or oligoarticular arthritis may develop in untreated patients. Antibiotic treatment is highly effective, but approximately 10% of treated patients experience persistent symptoms.
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