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181. Cardiac Amyloidosis.
Amyloidosis is a pathologic and clinical condition resulting from the accumulation of insoluble aggregates of misfolded proteins in tissues. Extracellular deposition of amyloid fibrils in the myocardium leads to cardiac amyloidosis, which is often overlooked as a cause of diastolic heart failure. Although cardiac amyloidosis was previously believed to have a poor prognosis, recent advances in diagnosis and treatment have emphasized the importance of early recognition and changed management of this condition. This article provides an overview of cardiac amyloidosis and summarizes current screening, diagnosis, evaluation, and treatment options.
182. Effect of Yoga on Frailty in Older Adults : A Systematic Review.
作者: Julia Loewenthal.;Kim E Innes.;Margalit Mitzner.;Carol Mita.;Ariela R Orkaby.
来源: Ann Intern Med. 2023年176卷4期524-535页
Yoga, a multicomponent mind-body practice, improves several domains of physical and psychological health and may affect frailty in older adults.
183. 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.
184. 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.
185. Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes : A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials.
作者: Anastassios G Pittas.;Tetsuya Kawahara.;Rolf Jorde.;Bess Dawson-Hughes.;Ellen M Vickery.;Edith Angellotti.;Jason Nelson.;Thomas A Trikalinos.;Ethan M Balk.
来源: Ann Intern Med. 2023年176卷3期355-363页
The role of vitamin D in people who are at risk for type 2 diabetes remains unclear.
186. Nonpharmacologic and Pharmacologic Treatments of Adults in the Acute Phase of Major Depressive Disorder: A Living Clinical Guideline From the American College of Physicians.
作者: Amir Qaseem.;Douglas K Owens.;Itziar Etxeandia-Ikobaltzeta.;Janice Tufte.;J Thomas Cross.;Timothy J Wilt.; .;Carolyn J Crandall.;Ethan Balk.;Thomas G Cooney.;Nick Fitterman.;Lauri A Hicks.;Jennifer S Lin.;Michael Maroto.;Adam J Obley.;Jeffrey A Tice.;Jennifer Yost.
来源: Ann Intern Med. 2023年176卷2期239-252页
The purpose of this guideline from the American College of Physicians (ACP) is to present updated clinical recommendations on nonpharmacologic and pharmacologic interventions as initial and second-line treatments during the acute phase of a major depressive disorder (MDD) episode, based on the best available evidence on the comparative benefits and harms, consideration of patient values and preferences, and cost.
187. Nonpharmacologic and Pharmacologic Treatments of Adult Patients With Major Depressive Disorder: A Systematic Review and Network Meta-analysis for a Clinical Guideline by the American College of Physicians.
作者: Gerald Gartlehner.;Andreea Dobrescu.;Andrea Chapman.;Ana Toromanova.;Robert Emprechtinger.;Emma Persad.;Lisa Affengruber.;Christoph Pieh.;Irma Klerings.;Gernot Wagner.
来源: Ann Intern Med. 2023年176卷2期196-211页
Primary care patients and clinicians may prefer alternative options to second-generation antidepressants for major depressive disorder (MDD).
188. Values and Preferences of Patients With Depressive Disorders Regarding Pharmacologic and Nonpharmacologic Treatments : A Rapid Review.
作者: Lisa Affengruber.;Gernot Wagner.;Andreea Dobrescu.;Ana Toromanova.;Andrea Chapman.;Emma Persad.;Irma Klerings.;Gerald Gartlehner.
来源: Ann Intern Med. 2023年176卷2期217-223页
Developers of clinical practice guidelines need to take patient values and preferences into consideration when weighing benefits and harms of treatment options for depressive disorder.
189. Cost-Effectiveness of First- and Second-Step Treatment Strategies for Major Depressive Disorder : A Rapid Review.
作者: Andreea Dobrescu.;Andrea Chapman.;Lisa Affengruber.;Emma Persad.;Ana Toromanova.;Gernot Wagner.;Irma Klerings.;Robert Emprechtinger.;Gerald Gartlehner.
来源: Ann Intern Med. 2023年176卷2期212-216页
Major depressive disorder (MDD) is the most prevalent, disabling form of depression, with a high economic effect.
190. Migraine.
Migraine affects about 1 billion people worldwide, and up to 15% of adults in the United States have migraine attacks in any given year. Migraine is associated with substantial adverse socioeconomic and personal effects. It is the second leading cause of years lived with disability worldwide for all ages and the leading cause in women aged 15 to 49 years. Diagnostic uncertainty increases the likelihood of unnecessary investigations and suboptimal management. This article advises clinicians about diagnosing migraine, ruling out secondary headache disorders, developing acute and preventive treatment plans, and deciding when to refer the patient to a specialist.
191. Diabetes Management in Chronic Kidney Disease: Synopsis of the KDIGO 2022 Clinical Practice Guideline Update.
作者: Sankar D Navaneethan.;Sophia Zoungas.;M Luiza Caramori.;Juliana C N Chan.;Hiddo J L Heerspink.;Clint Hurst.;Adrian Liew.;Erin D Michos.;Wasiu A Olowu.;Tami Sadusky.;Nikhil Tandon.;Katherine R Tuttle.;Christoph Wanner.;Katy G Wilkens.;Jonathan C Craig.;David J Tunnicliffe.;Marcello Tonelli.;Michael Cheung.;Amy Earley.;Peter Rossing.;Ian H de Boer.;Kamlesh Khunti.
来源: Ann Intern Med. 2023年176卷3期381-387页
The KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease is an update of the 2020 guideline from Kidney Disease: Improving Global Outcomes (KDIGO).
192. Pharmacologic Treatment of Primary Osteoporosis or Low Bone Mass to Prevent Fractures in Adults: A Living Clinical Guideline From the American College of Physicians.
作者: Amir Qaseem.;Lauri A Hicks.;Itziar Etxeandia-Ikobaltzeta.;Tatyana Shamliyan.;Thomas G Cooney.; .;J Thomas Cross.;Nick Fitterman.;Jennifer S Lin.;Michael Maroto.;Adam J Obley.;Jeffrey A Tice.;Janice E Tufte.
来源: Ann Intern Med. 2023年176卷2期224-238页
This guideline updates the 2017 American College of Physicians (ACP) recommendations on pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults.
193. Effectiveness and Safety of Treatments to Prevent Fractures in People With Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians.
作者: Chelsea Ayers.;Devan Kansagara.;Brittany Lazur.;Rongwei Fu.;Amy Kwon.;Curtis Harrod.
来源: Ann Intern Med. 2023年176卷2期182-195页
The prevalence of osteoporosis is increasing in the United States.
194. Monoclonal Gammopathy of Undetermined Significance.
Monoclonal gammopathy of undetermined significance (MGUS) is of considerable clinical importance to primary care physicians given its high prevalence in the general population. MGUS has a variable but lifelong risk for progression to hematologic cancer, such as multiple myeloma, Waldenström macroglobulinemia, or light-chain amyloidosis. In addition, MGUS has been associated with several nonmalignant yet symptomatic disorders that require therapy directed toward eliminating the monoclonal gammopathy. Thus, it is important not only to understand the essentials of diagnosing and monitoring patients with MGUS but also to recognize when to refer patients with MGUS to a specialist.
195. Major Update 2: Antibody Response and Risk for Reinfection After SARS-CoV-2 Infection-Final Update of a Living, Rapid Review.
作者: Haley K Holmer.;Katherine Mackey.;Celia V Fiordalisi.;Mark Helfand.
来源: Ann Intern Med. 2023年176卷1期85-91页
The durability of the antibody response after SARS-CoV-2 infection and the role of antibodies in protection against reinfection are unclear.
196. Outpatient Treatment of Confirmed COVID-19: A Living, Rapid Review for the American College of Physicians.
作者: Isolde Sommer.;Andreea Dobrescu.;Dominic Ledinger.;Isabel Moser.;Kylie Thaler.;Emma Persad.;Martin Fangmeyer.;Robert Emprechtinger.;Irma Klerings.;Gerald Gartlehner.
来源: Ann Intern Med. 2023年176卷1期92-104页
Clinicians and patients want to know the benefits and harms of outpatient treatment options for SARS-CoV-2 infection.
197. Health Care During Incarceration: A Policy Position Paper From the American College of Physicians.
作者: Newton E Kendig.;Renee Butkus.;Suja Mathew.;David Hilden.; .
来源: Ann Intern Med. 2022年175卷12期1742-1745页
The American College of Physicians (ACP) has a long-standing commitment to improving the health of all Americans and opposes any form of discrimination in the delivery of health care services. ACP is committed to working toward fully understanding and supporting the unique needs of the incarcerated population and eliminating health disparities for these persons. In this position paper, ACP offers recommendations to policymakers and administrators to improve the health and well-being of persons incarcerated in adult correctional facilities.
198. Preoperative Evaluation for Noncardiac Surgery.
The previous In the Clinic that addressed preoperative evaluation for noncardiac surgery was published in December 2016. This update reaffirms much of the information in the previous version and provides new information that has accumulated since then. The goal of preoperative assessment is to identify the risk for postoperative complications so health care teams can more fully understand how to implement strategies to mitigate risks before and after the operation.
199. Characteristics of High-Need, High-Cost Patients : A "Best-Fit" Framework Synthesis.
作者: Nancy D Berkman.;Eva Chang.;Julie Seibert.;Rania Ali.
来源: Ann Intern Med. 2022年175卷12期1728-1741页
Accurately identifying high-need, high-cost (HNHC) patients to reduce their preventable or modifiable health care use for their chronic conditions is a priority and a challenge for U.S. policymakers, health care delivery systems, and payers.
200. Environmental Health: A Position Paper From the American College of Physicians.
Environmental health refers to the health effects associated with environmental factors, such as air pollution, water contamination, and climate change. Environmental hazards are associated with poor outcomes in common diseases, including diabetes and heart disease. In this position paper, the American College of Physicians (ACP) seeks to inform physicians about environmental health and offers policymakers recommendations to reduce the adverse health consequences of climate change, improve air and water quality, reduce exposure to toxic substances, and address environmental injustice. ACP affirms that all communities, including people of color, people with low income, and marginalized populations, deserve to live in a healthy environment.
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