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3. Real-World Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation and Mitral Stenosis : A Target Trial Emulation.
作者: Yu Yang.;Chin-Yao Shen.;Michael Chun-Yuan Cheng.;Wei Kang.;Philip C M Au.;Vincent K C Yan.;Huei-Kai Huang.;Chun Ka Wong.;Kai Hang Yiu.;Hung-Fat Tse.;Ching-Lung Cheung.;Timothy H Rainer.;Bryan P Yan.;David C W Siu.;Ian Chi Kei Wong.;Edward Chia-Cheng Lai.;Esther W Y Chan.
来源: Ann Intern Med. 2026年
Whether direct oral anticoagulants (DOACs) are a safe and effective alternative to warfarin in patients with atrial fibrillation and mitral stenosis (AF-MS) remains controversial.
4. Inflammatory Bowel Disease.
The global burden of inflammatory bowel diseases (IBD) continues to rise, placing increasing demands on primary care and specialty practices alike. Beyond disease control, patients with IBD face heightened risks related to chronic inflammation and long-term immunosuppressive therapy, including infection, cancer, bone loss, nutritional deficiencies, and mental health disorders. Proactive, structured health care maintenance encompassing vaccination, cancer screening, bone and cardiometabolic health, nutrition, and psychosocial well-being is essential to optimize long-term outcomes. Effective delivery of this care depends on close collaboration and clearly defined shared responsibilities between gastroenterologists and primary care physicians. This review outlines evidence-based strategies for health care maintenance in the outpatient management of adults with IBD.
5. Surgery Versus Watchful Waiting for First Metatarsophalangeal Joint Osteoarthritis : A Randomized Controlled Trial.
作者: Mikko Miettinen.;Timo Sirola.;Tuomas Lähdeoja.;Henrik Sandelin.;Mari Nummela.;Jussi P Repo.;Ville Ponkilainen.;Lasse Rämö.
来源: Ann Intern Med. 2026年
Hallux rigidus, or osteoarthritis of the first metatarsophalangeal joint (MTPJ), causes pain and functional limitation. No randomized trials have compared surgery with the natural course of the disease.
8. How Would You Manage Perioperative Cardiovascular Risk for Noncardiac Surgery in This Patient With Complex Comorbidity? Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
作者: Howard Libman.;Avital Y O'Glasser.;Kirsten E Fleischmann.;Zahir Kanjee.
来源: Ann Intern Med. 2026年
Perioperative cardiovascular management involves the assessment and identification of risks in patients undergoing surgery, as well as development of a plan for mitigation of those risks during and after the procedure. It includes risk stratification, which provides guidance for preoperative testing and perioperative management in patients at high risk while avoiding overscreening in those at low risk. Specific guidance is informed by the patient's medical comorbid conditions, functional capacity, and type and urgency of planned surgery. In 2024, the American Heart Association, the American College of Cardiology, and other professional organizations published a comprehensive set of evidence-based recommendations for the evaluation and management of cardiovascular risk in adults undergoing noncardiac surgery. Its methodology included systematic literature review, multidisciplinary expert consensus, and peer review. Here, 2 experts in this field, a general internal medicine physician and a cardiologist, debate how to manage the case of an 80-year-old man with multiple cardiopulmonary conditions and other organ system comorbidities who is scheduled to undergo extensive skin cancer surgery. They discuss how to approach preoperative evaluation of such a patient with a focus on optimizing his status and monitoring for cardiac complications during and after the procedure.
12. In large-core ischemic stroke with onset in the past 24 h, EVT vs. medical therapy improves functional outcomes and reduces mortality at 90 d.
Emergency Med: [Formula: see text] Neurology: [Formula: see text].
16. Blood pressure-lowering drugs reduce risk for major cardiovascular events regardless of CKD G category.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Endocrinology: [Formula: see text] Nephrology: [Formula: see text].
17. In noncardioembolic ischemic stroke or high-risk TIA, asundexian reduced ischemic stroke and did not increase major bleeding.
GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text] Hematology: [Formula: see text].
18. In clinically stable ICH with hypertension, a triple pill of low-dose antihypertensive drugs reduced recurrence at a median 2.5 y.
GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].
19. Public Policy Approaches to Addressing Adult Obesity: A Position Paper From the American College of Physicians.
Forty percent of U.S. adults have obesity, a complex condition determined by genetics, behavior, environment, and other modifiable and nonmodifiable factors. Obesity is associated with certain comorbid conditions, including type 2 diabetes, high cholesterol, heart disease, and some cancer types, and may increase the severity of communicable illnesses, such as influenza. Treatments of obesity include behavioral modification, pharmacotherapy, and surgical procedures, but high cost and coverage restrictions are a substantial barrier for many patients. In this position paper, the American College of Physicians (ACP) offers recommendations on how policymakers can increase the affordability and accessibility of obesity treatment for adults and address modifiable factors that contribute to obesity, like diet and physical activity. ACP also includes recommendations on reducing stigma associated with obesity, improving understanding of obesity among physicians, increasing access to healthy food, and curbing the proliferation of unhealthy, highly processed fare. Population health strategies for addressing obesity are also discussed.
20. In adults with uncontrolled hypertension, a multifaceted team-based intervention vs. enhanced usual care improved BP control at 18 mo.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
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