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221. In adults with MI and LVEF >40% after invasive care, β-blocker therapy did not reduce a composite adverse outcome at a median 3.7 y.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
223. Asheville, North Carolina: The Origin of the American Tuberculosis Sanitarium Movement.
The digitization of academic publications and newspapers from the 1800s has permitted identification of several authoritative sources that credit Dr. Joseph W. Gleitsmann with establishing the first successful tuberculosis sanitarium in the United States in Asheville, North Carolina, in 1875, antedating by 9 years the Trudeau Sanatorium in Saranac Lake, New York. The facility used German climatological methods and a defined medical treatment program. Gleitsmann's Mountain Sanitarium for Pulmonary Diseases had a 30-bed occupancy and published outcomes data from 5 years of clinical experience by 1880. By 1910, Asheville had become a tuberculosis care "colony," with 25 private tuberculosis sanitaria with a national referral base. Asheville was a key driver of the development of climatotherapy in the treatment of tuberculosis and other respiratory ailments in the preantibiotic era. From 1870 to 1930, medical, mental health, and wellness tourism largely drove the population growth (1500 to 50 000) of Asheville, a previously remote Appalachian town. The stigmatization of tuberculosis sufferers is illustrated by restrictive municipal regulations that led to the demolition of almost all tuberculosis sanitaria within Asheville city limits by the 1920s. The Von Ruck Research Laboratory for Tuberculosis produced more than 50 papers from 1890 to 1930, published mostly in the Journal of the American Medical Association and the Journal of Immunology. These included pioneering immunotherapy studies with tuberculin variants and the first robust description of the antigenic profile of Mycobacterium tuberculosis. Tuberculosis was both incurable and a leading cause of death, and thus perseverance with fractionated tubercle bacillus products and subunits by so many is understandable in the context of the times. By analogy, public health now seems more ready to accept disease-specific immunotherapy agents and vaccines that save lives even if they are substantially less than 100% effective.
227. After successful PCI for AMI and 1 mo of DAPT, P2Y12 inhibitor monotherapy was noninferior to continued DAPT for adverse outcomes.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
228. In healthy older adults, low-dose aspirin for a median 4.7 y did not reduce MACE but increased major hemorrhage at a median 8.3 y.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Geriatrics: [Formula: see text] Public Health: [Formula: see text].
231. In patients with chronic coronary syndrome and high atherothrombotic risk, adding aspirin to OAC increased adverse CV events at 2 y.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
233. In CKD, electronic letter nudges for patients or providers did not increase RASi or SGLT2i prescriptions at 6 mo.
GIM/FP/GP: [Formula: see text] Nephrology: [Formula: see text].
235. Interventions to Improve Advance Care Planning Documentation in the Electronic Health Record : A Cluster Randomized Trial.
作者: Anne M Walling.;Rebecca L Sudore.;Lisa Gibbs.;Maryam Rahimi.;Ron D Hays.;Chi-Hong Tseng.;Kanan Patel.;Katherine Santos.;Fernando Javier Sanz Vidorreta.;Aaron J Chau.;Juan Carlos Antonio Lopez.;Jamie Anand.;G Rick Marshall.;Anna DePaolis-Dickey.;Kirsten I Buen.;Douglas S Bell.;Christine S Ritchie.;Victor Gonzalez.;Neil S Wenger.
来源: Ann Intern Med. 2026年179卷1期42-50页
Advance care planning (ACP) can improve communication of patients' preferences but is underutilized in health systems.
236. Principles of Managed Care: A Position Paper From the American College of Physicians.
Most U.S. health plans use managed care strategies, including health care use management and clinician networks. Most Medicare, Medicaid, and commercial insurance enrollees are covered by managed care plans. Managed care is ostensibly used to steer patients toward high-quality clinicians and facilities and contain costs; however, prior authorization, narrow clinician networks, and other managed care strategies often restrict access to necessary care, causing frustration among patients and physicians. In this position paper, the American College of Physicians offers policy recommendations to protect patients from onerous managed care processes, reduce administrative burdens associated with managed care, and ensure that patients can promptly access high-value, medically necessary care.
237. Effect of Nonmedical Cannabis Legalization and Exposure to Retail Stores on Cannabis Harms : A Quasi-experimental Study.
作者: Erik Loewen Friesen.;Michael Pugliese.;Rachael MacDonald-Spracklin.;Doug Manuel.;Kumanan Wilson.;Erin Hobin.;Andrew D Pinto.;Daniel T Myran.
来源: Ann Intern Med. 2026年179卷1期12-22页
In 2018, Canada became the second country to legalize nonmedical cannabis and the first to allow a commercial retail market. Limiting the density of stores selling other legal substances is associated with reductions in use and harms; however, similar associations for cannabis are not well established.
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