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701. Management of Heart Failure in Hospitalized Patients.
Heart failure affects more than 6 million people in the United States, and hospitalizations for decompensated heart failure confer a heavy toll in morbidity, mortality, and health care costs. Clinical trials have demonstrated effective interventions; however, hospitalization and mortality rates remain high. Key components of effective hospital care include appropriate diagnostic evaluation, triage and risk stratification, early implementation of guideline-directed medical therapy, adequate diuresis, and appropriate discharge planning.
702. Development and Validation of the CANHEART Population-Based Laboratory Prediction Models for Atherosclerotic Cardiovascular Disease.
作者: Maneesh Sud.;Atul Sivaswamy.;Peter C Austin.;Todd J Anderson.;David M J Naimark.;Michael E Farkouh.;Douglas S Lee.;Idan Roifman.;George Thanassoulis.;Karen Tu.;Jacob A Udell.;Harindra C Wijeysundera.;Dennis T Ko.
来源: Ann Intern Med. 2023年176卷12期1638-1647页
Prediction of atherosclerotic cardiovascular disease (ASCVD) in primary prevention assessments exclusively with laboratory results may facilitate automated risk reporting and improve uptake of preventive therapies.
703. Endoscopic En Bloc Versus Piecemeal Resection of Large Nonpedunculated Colonic Adenomas : A Randomized Comparative Trial.
作者: Jérémie Jacques.;Marion Schaefer.;Timothée Wallenhorst.;Thomas Rösch.;Vincent Lépilliez.;Stanislas Chaussade.;Jérôme Rivory.;Romain Legros.;Jean-Baptiste Chevaux.;Sarah Leblanc.;Florian Rostain.;Maximilien Barret.;Jérémie Albouys.;Arthur Belle.;Anaïs Labrunie.;Pierre-Marie Preux.;Hugo Lepetit.;Martin Dahan.;Thierry Ponchon.;Sabrina Crépin.;Loïc Marais.;Julien Magne.;Mathieu Pioche.
来源: Ann Intern Med. 2024年177卷1期29-38页
Endoscopic resection of adenomas prevents colorectal cancer, but the optimal technique for larger lesions is controversial. Piecemeal endoscopic mucosal resection (EMR) has a low adverse event (AE) rate but a variable recurrence rate necessitating early follow-up. Endoscopic submucosal dissection (ESD) can reduce recurrence but may increase AEs.
704. Second-Line Chimeric Antigen Receptor T-Cell Therapy in Diffuse Large B-Cell Lymphoma : A Cost-Effectiveness Analysis.
作者: Amar H Kelkar.;Edward R Scheffer Cliff.;Caron A Jacobson.;Gregory A Abel.;Stijntje W Dijk.;Eline M Krijkamp.;Robert Redd.;Joanna C Zurko.;Mehdi Hamadani.;M G Myriam Hunink.;Corey Cutler.
来源: Ann Intern Med. 2023年176卷12期1625-1637页
First-line treatment of diffuse large B-cell lymphoma (DLBCL) achieves durable remission in approximately 60% of patients. In relapsed or refractory disease, only about 20% achieve durable remission with salvage chemoimmunotherapy and consolidative autologous stem cell transplantation (ASCT). The ZUMA-7 (axicabtagene ciloleucel [axi-cel]) and TRANSFORM (lisocabtagene maraleucel [liso-cel]) trials demonstrated superior event-free survival (and, in ZUMA-7, overall survival) in primary-refractory or early-relapsed (high-risk) DLBCL with chimeric antigen receptor T-cell therapy (CAR-T) compared with salvage chemoimmunotherapy and consolidative ASCT; however, list prices for CAR-T exceed $400 000 per infusion.
705. In patients with HFpEF and obesity, semaglutide increased weight loss and reduced symptoms and physical limitations at 52 wk.
Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al; STEP-HFpEF Trial Committees and Investigators. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389:1069-1084. 37622681.
706. In older adults, postoperative oral haloperidol vs. antipsychotics was linked to similar risk for in-hospital adverse events.
Kim DH, Lee SB, Park CM, et al. Comparative safety analysis of oral antipsychotics for in-hospital adverse clinical events in older adults after major surgery: a nationwide cohort study. Ann Intern Med. 2023;176:1153-1162. 37665998.
707. In older adults, specialty geriatrics care, multicomponent interventions, and cognitive stimulation reduce nursing home admission.
Gaugler JE, Zmora R, Peterson CM, et al. What interventions keep older people out of nursing homes? A systematic review and meta-analysis. J Am Geriatr Soc. 2023;71:3609-3621. 37526432.
708. Adding piroxicam to levonorgestrel increased emergency contraception effectiveness.
Li RHW, Lo SST, Gemzell-Danielsson K, et al. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402:851-858. 37597523.
709. NSAIDs and hormonal contraceptives are linked to VTE in women with no previous thrombotic disease.
Meaidi A, Mascolo A, Sessa M, et al. Venous thromboembolism with use of hormonal contraception and non-steroidal anti-inflammatory drugs: nationwide cohort study. BMJ. 2023;382:e074450. 37673431.
710. In symptomatic adults undergoing high-resolution manometry, long-term opioid use was linked to esophageal dysmotility.
Niu C, Zhang J, Bapaye J, et al. Systematic review with meta-analysis: chronic opioid use is associated with esophageal dysmotility in symptomatic patients. Am J Gastroenterol. 18 Aug 2023. [Epub ahead of print]. 37463432.
711. In acute MI complicated by cardiogenic shock, ECLS did not reduce 30-d all-cause mortality.
Thiele H, Zeymer U, Akin I, et al; ECLS-SHOCK Investigators. Extracorporeal life support in infarct-related cardiogenic shock. N Engl J Med. 2023;389:1286-1297. 37634145.
712. USPSTF recommends PrEP using effective antiretroviral therapy in adults and adolescents at high risk for HIV.
US Preventive Services Task Force; Barry MJ, Nicholson WK, Silverstein M, et al. Preexposure prophylaxis to prevent acquisition of HIV: US Preventive Services Task Force Recommendation Statement. JAMA. 2023;330:736-745. 37606666.
713. In RA in remission for >1 y, tapering TNFi to discontinuation did not meet noninferiority criteria compared with stable TNFi for disease flare at 12 mo.
Lillegraven S, Paulshus Sundlisaeter N, Aga AB, et al. Effect of tapered versus stable treatment with tumour necrosis factor inhibitors on disease flares in patients with rheumatoid arthritis in remission: a randomised, open label, non-inferiority trial. Ann Rheum Dis. 2023;82:1394-1403. 37607809.
714. In symptomatic AF with end-stage HF, adding catheter ablation to medical therapy improved clinical outcomes at 18 mo.
Sohns C, Fox H, Marrouche NF, et al; CASTLE HTx Investigators. Catheter ablation in end-stage heart failure with atrial fibrillation. N Engl J Med. 2023;389:1380-1389. 37634135.
715. Impact of Finerenone-Induced Albuminuria Reduction on Chronic Kidney Disease Outcomes in Type 2 Diabetes : A Mediation Analysis.
作者: Rajiv Agarwal.;Wanzhu Tu.;Alfredo E Farjat.;Youssef M K Farag.;Robert Toto.;Sanjay Kaul.;Robert Lawatscheck.;Katja Rohwedder.;Luis M Ruilope.;Peter Rossing.;Bertram Pitt.;Gerasimos Filippatos.;Stefan D Anker.;George L Bakris.; .
来源: Ann Intern Med. 2023年176卷12期1606-1616页
In patients with chronic kidney disease (CKD) and type 2 diabetes (T2D), finerenone, a nonsteroidal mineralocorticoid receptor antagonist, reduces cardiovascular and kidney failure outcomes. Finerenone also lowers the urine albumin-to-creatinine ratio (UACR). Whether finerenone-induced change in UACR mediates cardiovascular and kidney failure outcomes is unknown.
716. Blood Pressure Effect of Traffic-Related Air Pollution : A Crossover Trial of In-Vehicle Filtration.
作者: Michael T Young.;Karen Jansen.;Kristen E Cosselman.;Timothy R Gould.;James A Stewart.;Timothy Larson.;Coralynn Sack.;Sverre Vedal.;Adam A Szpiro.;Joel D Kaufman.
来源: Ann Intern Med. 2023年176卷12期1586-1594页
Ambient air pollution, including traffic-related air pollution (TRAP), increases cardiovascular disease risk, possibly through vascular alterations. Limited information exists about in-vehicle TRAP exposure and vascular changes.
717. Cardiovascular Health of Middle-Aged U.S. Adults by Income Level, 1999 to March 2020 : A Serial Cross-Sectional Study.
作者: Michael Liu.;Rahul Aggarwal.;Zhaonian Zheng.;Robert W Yeh.;Dhruv S Kazi.;Karen E Joynt Maddox.;Rishi K Wadhera.
来源: Ann Intern Med. 2023年176卷12期1595-1605页
Although cardiovascular mortality has increased among middle-aged U.S. adults since 2011, how the burden of cardiovascular risk factors has changed for this population by income level over the past 2 decades is unknown.
718. Breast Cancer Screening and Prevention.
Breast cancer is the most common cancer among U.S. women and its incidence increases with age. Endogenous estrogen exposure, proliferative benign breast disease, breast density, and family history may also indicate increased risk for breast cancer. Early detection with screening mammography reduces breast cancer mortality, but the net benefits vary by age. Assessing a patient's individual breast cancer risk can guide decisions regarding breast cancer screening. All women benefit from healthy behaviors which may reduce breast cancer risk. Some women at increased risk for breast cancer may benefit from risk-reducing medications. Use of screening measures remains suboptimal, especially for uninsured women.
719. Rebound of COVID-19 With Nirmatrelvir-Ritonavir Antiviral Therapy.
In their article, Edelstein and colleagues provide the results of an observational study of virologic response in patients who received treatment with nirmatrelvir–ritonavir (N-R) versus those who received no COVID-19 therapy. The editorialists discuss the findings and emphasize the need for further consideration of the dosage, timing, and duration of treatment to inform optimal use of N-R.
720. Efficacy of Acupuncture for Chronic Spontaneous Urticaria : A Randomized Controlled Trial.
作者: Hui Zheng.;Xian-Jun Xiao.;Yun-Zhou Shi.;Lei-Xiao Zhang.;Wei Cao.;Qian-Hua Zheng.;Feng Zhong.;Ping-Sheng Hao.;Ying Huang.;Ming-Ling Chen.;Wei Zhang.;Si-Yuan Zhou.;Yan-Jun Wang.;Chuan Wang.;Li Zhou.;Xiao-Qin Chen.;Zuo-Qin Yang.;Zi-Hao Zou.;Ling Zhao.;Fan-Rong Liang.;Ying Li.
来源: Ann Intern Med. 2023年176卷12期1617-1624页
The effectiveness of acupuncture for patients with chronic spontaneous urticaria (CSU), reported in a few small-scale studies, is not convincing.
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