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1925. Symptom and Viral Rebound in Untreated SARS-CoV-2 Infection.
作者: Rinki Deo.;Manish C Choudhary.;Carlee Moser.;Justin Ritz.;Eric S Daar.;David A Wohl.;Alexander L Greninger.;Joseph J Eron.;Judith S Currier.;Michael D Hughes.;Davey M Smith.;Kara W Chew.;Jonathan Z Li.; .
来源: Ann Intern Med. 2023年176卷3期348-354页
Although symptom and viral rebound have been reported after nirmatrelvir-ritonavir treatment, the trajectories of symptoms and viral load during the natural course of COVID-19 have not been well described.
1926. Adenoma Detection Rate and Colorectal Cancer Risk in Fecal Immunochemical Test Screening Programs : An Observational Cohort Study.
作者: Manuel Zorzi.;Giulio Antonelli.;Claudio Barbiellini Amidei.;Jessica Battagello.;Bastianello Germanà.;Flavio Valiante.;Stefano Benvenuti.;Alberto Tringali.;Francesco Bortoluzzi.;Erica Cervellin.;Davide Giacomin.;Tamara Meggiato.;Erik Rosa-Rizzotto.;Diego Fregonese.;Manuela Dinca.;Gianluca Baldassarre.;Paola Scalon.;Maurizio Pantalena.;Luisa Milan.;Gianmarco Bulighin.;Daniele Di Piramo.;Maurizio Azzurro.;Armando Gabbrielli.;Alessandro Repici.;Douglas K Rex.;Massimo Rugge.;Cesare Hassan.; .;Anna Giacomin.;Andrea Buda.;Deborah Costa.;Davide Checchin.;Renato Marin.;Elisabetta Patarnello.;Aldo Ceriani.;Ennio Guido.;Perla Bertomoro.;Nicoletta Merlini.;Francesca Murer.;Ephrem Ntakirutimana.;Luca Benazzato.;Maria Cristina Conti Bellocchi.
来源: Ann Intern Med. 2023年176卷3期303-310页
Colorectal cancer (CRC) screening programs based on fecal immunochemical tests (FITs) represent the standard of care for population-based interventions. Their benefit depends on the identification of neoplasia at colonoscopy after FIT positivity. Colonoscopy quality measured by adenoma detection rate (ADR) may affect screening program effectiveness.
1927. Cold Versus Hot Snare Polypectomy for Small Colorectal Polyps : A Pragmatic Randomized Controlled Trial.
作者: Li-Chun Chang.;Chi-Yang Chang.;Chi-Yi Chen.;Cheng-Hao Tseng.;Peng-Jen Chen.;Chia-Tung Shun.;Wen-Feng Hsu.;Yen-Nien Chen.;Chieh-Chang Chen.;Tien-Yu Huang.;Chia-Hung Tu.;Mei-Jyh Chen.;Chu-Kuang Chou.;Ching-Tai Lee.;Po-Yueh Chen.;Ming-Shiang Wu.;Han-Mo Chiu.
来源: Ann Intern Med. 2023年176卷3期311-319页
Although cold snare polypectomy (CSP) is considered effective in reducing delayed postpolypectomy bleeding risk, direct evidence supporting its safety in the general population remains lacking.
1930. The Use of Opioids in the Management of Chronic Pain: Synopsis of the 2022 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.
作者: Friedhelm Sandbrink.;Jennifer L Murphy.;Melanie Johansson.;Juli L Olson.;Ellen Edens.;Jamie Clinton-Lont.;James Sall.;Christopher Spevak.; .
来源: Ann Intern Med. 2023年176卷3期388-397页
In May 2022, leadership within the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved a joint clinical practice guideline for the use of opioids when managing chronic pain. This synopsis summarizes the recommendations that the authors believe are the most important to highlight.
1931. How Would You Resuscitate This Patient With Septic Shock? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
作者: Zahir Kanjee.;Katherine Berg.;Taison D Bell.;Eileen E Reynolds.
来源: Ann Intern Med. 2023年176卷2期253-259页
Sepsis is a potentially life-threatening systemic dysregulatory response to infection, and septic shock occurs when sepsis leads to systemic vasodilation and subsequent tissue hypoperfusion. The Surviving Sepsis Campaign published updated guidelines in 2021 on the management of sepsis and septic shock. Here, in the context of a patient with septic shock, 2 critical care specialists discuss and debate conditional guideline recommendations on using lactate to guide resuscitation, the use of balanced crystalloids versus normal saline, and the use of corticosteroids.
1937. Chagas Disease.
Chagas disease, which is caused by infection with the parasite Trypanosoma cruzi, is a leading neglected tropical disease in the United States. An estimated 240 000 to 350 000 persons in the United States are infected, primarily immigrants from Mexico, Central America, and South America, where the disease is endemic. The parasite is transmitted by the triatomine bug but can also be passed through blood transfusion, via organ transplant, or congenitally. Approximately 30% of infected persons later develop cardiac and/or gastrointestinal complications. Health care providers should consider screening at-risk patients with serologic testing. Early diagnosis and treatment with benznidazole or nifurtimox can help prevent complications.
1940. In basilar-artery occlusion stroke, thrombectomy improved functional outcomes without increasing ICH.
Jovin TG, Li C, Wu L, et al. Trial of thrombectomy 6 to 24 hours after stroke due to basilar-artery occlusion. N Engl J Med. 2022;387:1373-84. 36239645.
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