21. Comparison of Semaglutide or Dulaglutide Versus Empagliflozin for Risk for Death and Cardiovascular Outcomes Among Patients With Type 2 Diabetes : Two Target Trial Emulation Studies.
作者: Anum Saeed.;Suresh R Mulukutla.;Floyd Thoma.;Lara Lemon.;Agnes Koczo.;Steven Reis.;Oscar Marroquin.;Kevin Kip.
来源: Ann Intern Med. 2025年
Reduction of premature death and adverse cardiovascular outcomes is a key goal in type 2 diabetes management.
22. Projected Effects of Proposed Cuts in Federal Medicaid Expenditures on Medicaid Enrollment, Uninsurance, Health Care, and Health.
In January 2025, the Republican majority in the House of Representatives' Budget Committee offered a list of possible spending reductions to offset revenue losses from proposed tax cuts. In May, the Committee advanced a bill incorporating several reductions on the list. The Committee estimated that the 6 largest potential Medicaid cuts (for example, work requirements for some Medicaid enrollees) would each reduce the federal government's Medicaid outlays by at least $100 billion over 10 years. On the basis of the Committee's estimates of savings; Congressional Budget Office analyses; and peer-reviewed studies of the coverage, financial, and health impacts of past Medicaid expansions and contractions, the authors project the likely effects of each option and of the House bill advanced by the Budget Committee in May. Each option individually would reduce federal Medicaid outlays by between $100 billion and $900 billion over a decade, increase the ranks of the uninsured by between 600 000 and 3 900 000 and the annual number of persons forgoing needed medical care by 129 060 to 838 890, and result in 651 to 12 626 medically preventable deaths annually. Enactment of the House bill advanced in May would increase the number of uninsured persons by 7.6 million and the number of deaths by 16 642 annually, according to a mid-range estimate. These figures exclude harms from lowering provider payments and shrinking benefits, as well as possible repercussions from states increasing taxes or shifting expenditures from other needs to make up for shortfalls in federal Medicaid funding. Policy makers should weigh the likely health and financial harms to patients and providers of reducing Medicaid expenditures against the desirability of tax reductions, which would accrue mostly to wealthy Americans.
23. Screening for Anal Cancer Among Men Who Have Sex With Men With HIV: Benefits, Harms, and Cost-Effectiveness Analyses.
作者: Ashish A Deshmukh.;Haluk Damgacioglu.;Keith Sigel.;Joel M Palefsky.;Megan A Clarke.;Nicolas Wentzensen.;Alan G Nyitray.;Ana Patricia Ortiz.;Yueh-Yun Lin.;Elizabeth Y Chiao.;Elizabeth Stier.;Naomi Jay.;Michael Gaisa.;Yuxin Liu.;Eric G Meissner.;Gweneth Lazenby.;Anna R Giuliano.;Stephen E Goldstone.;Gary M Clifford.;Kalyani Sonawane.;Jagpreet Chhatwal.
来源: Ann Intern Med. 2025年
Following the success of the ANCHOR (Anal Cancer-HSIL Outcomes Research) trial, the U.S. Department of Health and Human Services recommends anal cancer screening for high-risk persons, particularly men who have sex with men (MSM) with HIV.
24. Fecal Microbiota Transplantation Versus Vancomycin for Primary Clostridioides difficile Infection : A Randomized Controlled Trial.
作者: Frederik Emil Juul.;Michael Bretthauer.;Peter H Johnsen.;Faye Samy.;Kristian Tonby.;Jan Erik Berdal.;Dag Arne L Hoff.;Eirik H Ofstad.;Awet Abraham.;Birgitte Seip.;Håvard Wiig.;Øyvind Bakken Rognstad.;Ida F Glad.;Jørgen Valeur.;Axel E Nissen-Lie.;Eivind Ness-Jensen.;Kristine M A Lund.;Linn K Skjevling.;Kurt Hanevik.;Hilde Skudal.;Ellen J Melsom.;Raziye Boyar.;Trond J Cooper.;Trond E Ranheim.;Esben M Riise.;Hans-Olov Adami.;Mette Kalager.;Magnus Løberg.;Kjetil K Garborg.
来源: Ann Intern Med. 2025年
Fecal microbiota transplantation (FMT) is recommended for recurrent Clostridioides difficile infection (CDI), but its role in primary CDI is unclear.
25. Birth Cohort Effects in Appendiceal Adenocarcinoma Incidence Across the United States.
作者: Andreana N Holowatyj.;Mary K Washington.;Richard M Goldberg.;Caitlin C Murphy.
来源: Ann Intern Med. 2025年
Incidence rates of appendiceal adenocarcinoma (AA) are increasing across all age groups in the United States. Birth cohort patterns of AA can provide new, etiologic clues into increasing rates but have not been examined.
26. What Would You Recommend for This Patient Interested in a Total Knee Joint Arthroplasty? Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
作者: Risa B Burns.;Tara Skorupa.;Ayesha Abdeen.;Zahir Kanjee.
来源: Ann Intern Med. 2025年178卷6期858-867页
Fourteen million people in the United States have symptomatic knee osteoarthritis (OA), a number that is expected to rise with an aging population. Patients with OA can benefit from nonoperative treatment. However, none of these treatments are disease modifying, and many patients eventually require total joint arthroplasty (TJA). The American College of Rheumatology and the American Association of Hip and Knee Surgeons recently issued a guideline on the optimal timing of TJA in patients with symptomatic moderate-to-severe OA for whom nonoperative therapy has been ineffective. In this article, 2 experts review the available evidence and discuss options for nonoperative treatment and the indications for and timing of operative therapy.
27. Care of the Patient With Asthma.
Nearly 8% of the U.S. population is diagnosed with asthma, leading to more than 5 million office visits and 1 million emergency department visits annually. Both outpatient and inpatient internal medicine clinicians treat asthma frequently, but nuances in diagnosis and management have emerged. This article highlights many of these developments.
28. Effects of a Hypotension-Avoidance Versus a Hypertension-Avoidance Strategy on Neurocognitive Outcomes After Noncardiac Surgery.
作者: Maura Marcucci.;Matthew T V Chan.;Thomas W Painter.;Sergey Efremov.;Hector J Aguado.;Sergey V Astrakov.;Ydo V Kleinlugtenbelt.;Ameen Patel.;Juan P Cata.;Mohammed Amir.;Mikhail Kirov.;Kate Leslie.;Emmanuelle Duceppe.;Flavia K Borges.;Miriam de Nadal.;Vikas Tandon.;Giovanni Landoni.;Valery V Likhvantsev.;Vladimir Lomivorotov.;Daniel I Sessler.;María José Martínez-Zapata.;Denis Xavier.;Edith Fleischmann.;Chew Yin Wang.;Christian S Meyhoff.;Maria Wittmann.;David Torres.;David Highton.;Michael Jacka.;Vishwanath B.;Kelly Zarnke.;Ravinder Singh Sidhu.;Giorgio Oriani.;Sabry Ayad.;Steven Minear.;Tristan E Weaver.;Kurt Ruetzler.;Claudia Brusasco.;Joel L Parlow.;Elizabeth Maxwell.;Scott Miller.;Marko Mrkobrada.;Keyur Suresh Chandra Bhatt.;Prashant Rahate.;Ana Kowark.;Giuseppe De Blasio.;Sandra N Ofori.;David Conen.;Sadeesh Srinathan.;Wojciech Szczeklik.;Raja Jayaram.;Richard K Ellerkmann.;Mona Momeni.;Ingrid Copland.;Jessica Vincent.;Kumar Balasubramanian.;Zhuoru Li.;Michael Ke Wang.;Deyang Li.;Michael H McGillion.;Andrea Kurz.;Mukul Sharma.;Timothy G Short.;P J Devereaux.; .
来源: Ann Intern Med. 2025年
Perioperative hemodynamic abnormalities have been associated with neurocognitive outcomes after noncardiac surgery.
29. In active lupus nephritis, adding obinutuzumab to standard therapy increased complete renal response rates at 76 wk.
GIM/FP/GP: [Formula: see text] Nephrology: [Formula: see text] Rheumatology: [Formula: see text].
30. In VTE at high risk for recurrence, reduced- vs. full-dose DOACs did not differ for symptomatic recurrence but reduced bleeding at 37 mo.
GIM/FP/GP: [Formula: see text] Hematology: [Formula: see text].
31. In AF with stable CAD, an OAC alone does not increase ischemic events and reduces major bleeding vs. OAC + SAPT at a mean 22 mo.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
32. In ACS with DES, de-escalating DAPT to ticagrelor alone vs. standard DAPT reduces major bleeding without increasing ischemic events.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].
33. In type 2 diabetes with CKD and additional CV risk factors, sotagliflozin reduced total MACE vs. placebo at a median 14 mo.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Endocrinology: [Formula: see text] Nephrology: [Formula: see text].
34. SCCM made 4 conditional recommendations for managing symptoms in adults admitted to the ICU.
作者: Brian Osorio.;Irene Vargas.;Saraschandra Vallabhajosyula.; .
来源: Ann Intern Med. 2025年178卷6期JC62页
GIM/FP/GP: [Formula: see text] Critical Care: [Formula: see text].
35. In untreated Graves disease, adding methotrexate to methimazole increased euthyroidism-related treatment discontinuation at 18 mo.
GIM/FP/GP: [Formula: see text] Endocrinology: [Formula: see text].
36. In survivors of ICH with AF, DOACs reduced incident ischemic stroke and increased recurrent ICH at a median 1.4 y.
Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Neurology: [Formula: see text] Hematology: [Formula: see text].
37. Link between compliance with, or implementation of, the SEP-1 sepsis bundle and mortality is mixed (low-level evidence).
GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text] Critical Care: [Formula: see text].
39. Statin Therapy as Primary Prevention for Persons With HIV: A Synopsis of Recommendations From the U.S. Department of Health and Human Services Antiretroviral Treatment Guidelines Panel.
作者: Craig Beavers.;Alice K Pau.;David Glidden.;Emily Hyle.;Safia Kuriakose.;Seth S Martin.;Grace McComsey.;Melanie Thompson.;Salim Virani.;Jason V Baker.
来源: Ann Intern Med. 2025年178卷6期847-857页
REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) showed benefits of pitavastatin as preventive therapy for atherosclerotic cardiovascular disease (ASCVD) in people with HIV (PWH). In February 2024, the U.S. Department of Health and Human Services Panel for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (ARV Guidelines Panel) developed statin therapy recommendations for PWH. These recommendations were issued in collaboration with representatives from the American College of Cardiology (ACC), the American Heart Association (AHA), and the HIV Medicine Association (HIVMA). This synopsis summarizes the development process, the recommendations, and how they supplement the AHA/ACC/multisociety cholesterol guidelines and outlines gaps in primary prevention of ASCVD for PWH.
40. Associations Between Unconditional Cash Transfers and Postpartum Outcomes in the United States : A Systematic Review.
作者: Sahar A Choudhry.;G Saradjha Brédy.;Cyerra Cruise.;Qai Hinds.;Margaret A McConnell.;Sumit Agarwal.;David B Flynn.;Mara E Murray Horwitz.
来源: Ann Intern Med. 2025年
Unconditional cash transfers (UCTs) through social programs or direct cash transfers (DCTs) may address drivers of pregnancy-related morbidity and mortality.
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