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1881. In CKD, once-daily empagliflozin reduced progression of kidney disease or CV death at 2 y.
EMPA-KIDNEY Collaborative Group; Herrington WG, Staplin N, Wanner C, et al. Empagliflozin in patients with chronic kidney disease. N Engl J Med. 2023;388:117-27. 36331190.
1882. SGLT2 inhibitors reduce adverse renal and CV outcomes in patients with or without diabetes.
Nuffield Department of Population Health Renal Studies Group; SGLT2 inhibitor Meta-Analysis Cardio-Renal Trialists' Consortium. Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. Lancet. 2022;400:1788-801. 36351458.
1883. Antihypertensive therapy reduced incident dementia vs. placebo at a median 4.3 y.
Peters R, Xu Y, Fitzgerald O, et al. Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis. Eur Heart J. 2022;43:4980-90. 36282295.
1884. In acute HF in the ED, a risk-based management algorithm vs. usual care reduced a composite clinical outcome at 30 d.
Lee DS, Straus SE, Farkouh ME, et al. Trial of an intervention to improve acute heart failure outcomes. N Engl J Med. 2023;388:22-32. 36342109.
1885. In adults with acute HF, high-intensity care vs. usual care reduced a composite of death or HF readmission at 180 d.
Mebazaa A, Davison B, Chioncel O, et al. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. Lancet. 2022;400:1938-52. 36356631.
1886. In AF, underdosing of DOACs was not linked to reduced bleeding.
Caso V, de Groot JR, Sanmartin Fernandez M, et al. Outcomes and drivers of inappropriate dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a systematic review and meta-analysis. Heart. 2023;109:178-85. 36316100.
1887. In advanced progressive CKD, discontinuing RAS inhibitors did not improve eGFR at 3 y.
Bhandari S, Mehta S, Khwaja A, et al. Renin-angiotensin system inhibition in advanced chronic kidney disease. N Engl J Med. 2022;387:2021-32. 36326117.
1889. Mycobacterium abscessus Cluster in Cardiac Surgery Patients Potentially Attributable to a Commercial Water Purification System.
作者: Michael Klompas.;Chidiebere Akusobi.;Jon Boyer.;Ann Woolley.;Ian D Wolf.;Robert Tucker.;Chanu Rhee.;Karen Fiumara.;Madelyn Pearson.;Charles A Morris.;Eric Rubin.;Meghan A Baker.
来源: Ann Intern Med. 2023年176卷3期333-339页
Nontuberculous mycobacteria are water-avid pathogens that are associated with nosocomial infections.
1891. Comparison of Over-the-Scope Clips to Standard Endoscopic Treatment as the Initial Treatment in Patients With Bleeding From a Nonvariceal Upper Gastrointestinal Cause : A Randomized Controlled Trial.
作者: James Y W Lau.;Rui Li.;Chen-Huan Tan.;Xiu-Jing Sun.;Hao-Jun Song.;Lan Li.;Feng Ji.;Bu-Jiang Wang.;Dong-Tao Shi.;Wai K Leung.;Imogen Hartley.;Alan Moss.;Karina Y Y Yu.;Bing Y Suen.;Peng Li.;Francis K L Chan.
来源: Ann Intern Med. 2023年176卷4期455-462页
Current endoscopic methods in the control of acute nonvariceal bleeding have a small but clinically significant failure rate. The role of over-the-scope clips (OTSCs) as the first treatment has not been defined.
1893. Long-Term Changes in the Size of Pituitary Microadenomas.
作者: Dawid Hordejuk.;Yee-Ming M Cheung.;Wei Wang.;Timothy Smith.;Edward Laws.;Ursula B Kaiser.;Le Min.
来源: Ann Intern Med. 2023年176卷3期298-302页
The estimated prevalence of pituitary lesions is 10% to 38.5% in radiologic studies. However, how frequently these incidental lesions should be monitored by serial pituitary magnetic resonance imaging (MRI) remains unclear.
1895. Recommended and Prevalent Use of Glucagon-like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter-2 Inhibitors in a National Population-Based Sample.1896. Reproductive Health Policy in the United States: An American College of Physicians Policy Brief.
The legal landscape around access to reproductive health care services was substantially altered after the Supreme Court decision in Dobbs v Jackson Women's Health Organization. In the aftermath of the decision, some state governments have begun to impose stringent restrictions and complete bans on the provision of abortion, whereas others have sought to protect and expand access. Some have gone as far as imposing criminal and civil penalties on physicians and other clinicians who provide evidence-based, clinically indicated reproductive health care services and information that is guided by biomedical ethics and provided in the best interest of the patient's health and well-being. In several states, lawmakers have attempted and successfully used new approaches to enforcing and achieving these prohibitions, including prohibitions on crossing state lines to obtain abortion care, prohibitions on the mailing of medication abortion, and the authorization of third-party civil lawsuits. In this policy brief, the American College of Physicians (ACP) updates and expands on its previous public policy positions on abortion from its 2018 policy paper, "Women's Health Policy in the United States," to reflect this new reality. The College also offers policymakers and payers recommendations to promote equitable access to reproductive health care services and safeguard maternal health. ACP reaffirms its opposition to undue and unnecessary governmental interference in the patient-physician relationship that criminalizes the provision of health care made in the physician's clinical judgment and based on clinical evidence and the standard of care.
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