2721. Extending a Lifeline to Nonhospitalized Patients With COVID-19 Through Automated Text Messaging.
In their article, Delgado and colleagues reported observed outcomes of an automated, text message–based monitoring program with 24/7 clinical support, implemented to monitor nonhospitalized patients with COVID-19. The editorialists discuss the findings and note factors that contributed to the intervention's success.
2727. Influenza.
Seasonal influenza epidemics of variable severity pose challenges to public health. Annual vaccination is the primary way to prevent influenza, and a wide range of vaccines are available, including inactivated or live attenuated standard-dose, recombinant vaccines, as well as adjuvanted or high-dose vaccines for persons aged 65 years or older. Persons at increased risk for influenza complications include young children, persons with underlying medical conditions, and older adults. Prompt diagnosis of influenza can facilitate early initiation of antiviral treatment that provides the greatest clinical benefit. This article summarizes recommendations for providers on influenza vaccination, diagnostic testing, and antiviral treatment.
2728. Comparative Implementation of a Brief App-Directed Protocol for Delirium Identification by Hospitalists, Nurses, and Nursing Assistants : A Cohort Study.
作者: Edward R Marcantonio.;Donna M Fick.;Yoojin Jung.;Sharon K Inouye.;Marie Boltz.;Douglas L Leslie.;Erica K Husser.;Priyanka Shrestha.;Amber Moore.;Kimberlyann Sulmonte.;Jonathan Siuta.;Malaz Boustani.;Long H Ngo.
来源: Ann Intern Med. 2022年175卷1期65-73页
Systematic screening improves delirium identification among hospitalized older adults. Little data exist on how to implement such screening.
2729. Long-Term Follow-up of the Italian Flexible Sigmoidoscopy Screening Trial.
作者: Carlo Senore.;Emilia Riggi.;Paola Armaroli.;Luigina Bonelli.;Stefania Sciallero.;Marco Zappa.;Arrigo Arrigoni.;Claudia Casella.;Cristiano Crosta.;Fabio Falcini.;Franco Ferrero.;Mario Fracchia.;Orietta Giuliani.;Mauro Risio.;Antonio G Russo.;Carmen Beatriz Visioli.;Stefano Rosso.;Nereo Segnan.; .
来源: Ann Intern Med. 2022年175卷1期36-45页
Recent reports showed that the protective effect of flexible sigmoidoscopy (FS) screening was maintained up to17 years, although differences were reported by sex.
2730. COVID-19 Vaccine Boosters for All Adults: An Optimal U.S. Approach?
作者: Ameet Sarpatwari.;Ankur Pandya.;Emily P Hyle.;Govind Persad.
来源: Ann Intern Med. 2022年175卷2期280-282页
In this commentary, the authors discuss the potential benefits and harms of boosters in response to a boosters-for-all policy for Americans, as well as provide 3 plausible alternative strategies.
2731. Current Insights Into Respiratory Virus Transmission and Potential Implications for Infection Control Programs : A Narrative Review.
作者: Michael Klompas.;Donald K Milton.;Chanu Rhee.;Meghan A Baker.;Surbhi Leekha.
来源: Ann Intern Med. 2021年174卷12期1710-1718页
Policies to prevent respiratory virus transmission in health care settings have traditionally divided organisms into Droplet versus Airborne categories. Droplet organisms (for example, influenza) are said to be transmitted via large respiratory secretions that rapidly fall to the ground within 1 to 2 meters and are adequately blocked by surgical masks. Airborne pathogens (for example, measles), by contrast, are transmitted by aerosols that are small enough and light enough to carry beyond 2 meters and to penetrate the gaps between masks and faces; health care workers are advised to wear N95 respirators and to place these patients in negative-pressure rooms. Respirators and negative-pressure rooms are also recommended when caring for patients with influenza or SARS-CoV-2 who are undergoing "aerosol-generating procedures," such as intubation. An increasing body of evidence, however, questions this framework. People routinely emit respiratory particles in a range of sizes, but most are aerosols, and most procedures do not generate meaningfully more aerosols than ordinary breathing, and far fewer than coughing, exercise, or labored breathing. Most transmission nonetheless occurs at close range because virus-laden aerosols are most concentrated at the source; they then diffuse and dilute with distance, making long-distance transmission rare in well-ventilated spaces. The primary risk factors for nosocomial transmission are community incidence rates, viral load, symptoms, proximity, duration of exposure, and poor ventilation. Failure to appreciate these factors may lead to underappreciation of some risks (for example, overestimation of the protection provided by medical masks, insufficient attention to ventilation) or misallocation of limited resources (for example, reserving N95 respirators and negative-pressure rooms only for aerosol-generating procedures or requiring negative-pressure rooms for all patients with SARS-CoV-2 infection regardless of stage of illness). Enhanced understanding of the factors governing respiratory pathogen transmission may inform the development of more effective policies to prevent nosocomial transmission of respiratory pathogens.
2735. Black patients with COVID-19 had increased risk for 30-d mortality, PE, and other adverse outcomes vs. White patients.
Metra B, Summer R, Brooks SE, et al. Racial disparities in COVID-19 associated pulmonary embolism: a multicenter cohort study. Thromb Res. 2021;205:84-91. 34274560.
2736. Recommendations were made for diagnosis and management of allergic reactions to COVID-19 vaccines.
Greenhawt M, Abrams EM, Shaker M, et al. The risk of allergic reaction to SARS-CoV-2 vaccines and recommended evaluation and management: a systematic review, meta-analysis, GRADE assessment, and international consensus approach. J Allergy Clin Immunol Pract. 2021;9:3546-67. 34153517.
2737. BioNTech/Pfizer vaccine after Oxford/AZ vaccine increased immune response vs. no second vaccine.
Borobia AM, Carcas AJ, Perez-Olmeda M, et al. Immunogenicity and reactogenicity of BNT162b2 booster in ChAdOx1-S-primed participants (CombiVacS): a multicentre, open-label, randomised, controlled, phase 2 trial. Lancet. 2021;398:121-30. 34181880.
2738. Trends in Outpatient Care for Medicare Beneficiaries and Implications for Primary Care, 2000 to 2019.
作者: Michael L Barnett.;Asaf Bitton.;Jeff Souza.;Bruce E Landon.
来源: Ann Intern Med. 2021年174卷12期1658-1665页
Despite the central role of primary care in improving health system performance, there are little recent data on how use of primary care and specialists has evolved over time and its implications for the range of care coordination needed in primary care.
2739. A Primary Care-Based Cognitive Behavioral Therapy Intervention for Long-Term Opioid Users With Chronic Pain : A Randomized Pragmatic Trial.
作者: Lynn DeBar.;Meghan Mayhew.;Lindsay Benes.;Allison Bonifay.;Richard A Deyo.;Charles R Elder.;Francis J Keefe.;Michael C Leo.;Carmit McMullen.;Ashli Owen-Smith.;David H Smith.;Connie M Trinacty.;William M Vollmer.
来源: Ann Intern Med. 2022年175卷1期46-55页
Chronic pain is common, disabling, and costly. Few clinical trials have examined cognitive behavioral therapy (CBT) interventions embedded in primary care settings to improve chronic pain among those receiving long-term opioid therapy.
2740. Update on and Future Directions for Use of Anti-SARS-CoV-2 Antibodies: National Institutes of Health Summit on Treatment and Prevention of COVID-19.
作者: César Boggiano.;Robert W Eisinger.;Andrea M Lerner.;James M Anderson.;Janet Woodcock.;Anthony S Fauci.;Francis S Collins.
来源: Ann Intern Med. 2022年175卷1期119-126页
As the fourth wave of the SARS-CoV-2 pandemic encircles the globe, there remains an urgent challenge to identify safe and effective treatment and prevention strategies that can be implemented in a range of health care and clinical settings. Substantial advances have been made in the use of anti-SARS-CoV-2 antibodies to mitigate the morbidity and mortality associated with COVID-19. On 15 June 2021, the National Institutes of Health, in collaboration with the U.S. Food and Drug Administration, convened a virtual summit to summarize existing knowledge on anti-SARS-CoV-2 antibodies and to identify key unanswered scientific questions to further catalyze the clinical development and implementation of antibodies.
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