841. Clinical Characteristics and Outcomes Among Travelers With Severe Dengue : A GeoSentinel Analysis.
作者: Ralph Huits.;Kristina M Angelo.;Bhawana Amatya.;Sapha Barkati.;Elizabeth D Barnett.;Emmanuel Bottieau.;Hannah Emetulu.;Loïc Epelboin.;Gilles Eperon.;Line Medebb.;Federico Gobbi.;Martin P Grobusch.;Oula Itani.;Sabine Jordan.;Paul Kelly.;Karin Leder.;Marta Díaz-Menéndez.;Nobumasa Okumura.;Aisha Rizwan.;Camilla Rothe.;Mauro Saio.;Jesse Waggoner.;Yukihiro Yoshimura.;Michael Libman.;Davidson H Hamer.;Eli Schwartz.
来源: Ann Intern Med. 2023年176卷7期940-948页
Dengue virus is a flavivirus transmitted by Aedes mosquitoes and is an important cause of illness worldwide. Data on the severity of travel-associated dengue illness are limited.
842. How Would You Manage This Patient With Recurrent Diverticulitis? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
作者: Howard Libman.;Judy W Nee.;Anthony J Lembo.;Risa B Burns.
来源: Ann Intern Med. 2023年176卷6期836-843页
Acute diverticulitis, which refers to inflammation or infection, or both, of a colonic diverticulum, is a common medical condition that may occur repeatedly in some persons. It most often manifests with left-sided abdominal pain, which may be associated with low-grade fever and other gastrointestinal symptoms. Complications may include abscess, fistula formation, perforation, and bowel obstruction. The American College of Physicians recently published practice guidelines on the diagnosis and management of acute diverticulitis, the role of colonoscopy after resolution, and interventions to prevent recurrence of this condition. Among the recommendations were the use of abdominal computed tomography (CT) scanning in cases where there was diagnostic uncertainty, initial management of uncomplicated cases in the outpatient setting without antibiotics, referral for colonoscopy after an initial episode if not performed recently, and discussion of elective surgery to prevent recurrent disease in patients with complicated diverticulitis or frequent episodes of uncomplicated disease. Here, 2 gastroenterologists with expertise in acute diverticulitis debate CT scanning for diagnosis, antibiotics for treatment, colonoscopy to screen for underlying malignancy, and elective surgery to prevent recurrent disease.
843. Dyslipidemia.
Dyslipidemia is an important risk factor for coronary artery disease and stroke. All persons with dyslipidemia should be advised to focus on lifestyle interventions, including regular aerobic exercise, a healthy diet, maintenance of a healthy weight, and abstinence from smoking. In addition to lifestyle interventions, lipid-lowering therapy should be considered for persons at moderate to high risk for atherosclerotic cardiovascular disease based on validated risk equations. Statin therapy is the first-line medical treatment for dyslipidemia due to its effectiveness and favorable adverse effect profile, but newer treatments provide additional tools for clinicians to effectively treat dyslipidemia.
844. In older adults, an Ad26.RSV.preF-RSV preF protein vaccine reduced RSV-related lower respiratory tract disease.
Falsey AR, Williams K, Gymnopoulou E, et al; CYPRESS Investigators. Efficacy and safety of an Ad26.RSV.preF-RSV preF protein vaccine in older adults. N Engl J Med. 2023;388:609-620. 36791161.
845. After ICH, starting long-term therapeutic oral anticoagulation in patients with AF reduces MACE at 1 to 3 y.
Cochrane A, Chen C, Stephen J, et al. Antithrombotic treatment after stroke due to intracerebral haemorrhage. Cochrane Database Syst Rev. 2023;1:CD012144. 36700520.
846. In TB, an 8-wk, 5-drug regimen was noninferior to a standard 24-wk, 4-drug regimen for clinical outcomes at 96 wk.
Paton NI, Cousins C, Suresh C, et al; TRUNCATE-TB Trial Team. Treatment strategy for rifampin-susceptible tuberculosis. N Engl J Med. 2023;388:873-887. 36808186.
847. In severe tricuspid regurgitation, tricuspid TEER improved QoL more than medical therapy at 1 y.
Sorajja P, Whisenant B, Hamid N, et al; TRILUMINATE Pivotal Investigators. Transcatheter repair for patients with tricuspid regurgitation. N Engl J Med. 4 Mar 2023. [Epub ahead of print]. 36876753.
848. In older adults, an AS01E-adjuvanted RSVPreF3 OA vaccine reduced RSV-related lower respiratory tract disease.
Papi A, Ison MG, Langley JM, et al; AReSVi-006 Study Group. Respiratory syncytial virus prefusion F protein vaccine in older adults. N Engl J Med. 2023;388:595-608. 36791160.
849. Genotype-guided drug prescribing vs. usual care reduced clinically relevant adverse drug reactions at 12 wk.
Swen JJ, van der Wouden CH, Manson LE, et al; Ubiquitous Pharmacogenetics Consortium. A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study. Lancet. 2023;401:347-356. 36739136.
850. P2Y12 inhibitor monotherapy 1 to 3 mo after PCI did not differ from standard DAPT for fatal or ischemic events.
Gragnano F, Mehran R, Branca M; Single Versus Dual Antiplatelet Therapy (Sidney-2) Collaboration. P2Y12 inhibitor monotherapy or dual antiplatelet therapy after complex percutaneous coronary interventions. J Am Coll Cardiol. 2023;81:537-552. 36754514.
851. In large acute ischemic stroke, adding endovascular thrombectomy to medical therapy improved function at 90 d.
Sarraj A, Hassan AE, Abraham MG, et al; SELECT2 Investigators. Trial of endovascular thrombectomy for large ischemic strokes. N Engl J Med. 2023;388:1259-1271. 36762865.
852. In symptomatic PAH, adding sotatercept to stable background therapy improved 6-min walk distance at 24 wk.
Hoeper MM, Badesch DB, Ghofrani HA, et al; STELLAR Trial Investigators. Phase 3 trial of sotatercept for treatment of pulmonary arterial hypertension. N Engl J Med. 2023;388:1478-1490. 36877098.
853. In hypertension not treated with medications, renal denervation vs. sham reduced daytime ambulatory SBP at 2 mo.
Azizi M, Saxena M, Wang Y, et al; RADIANCE II Investigators and Collaborators. Endovascular ultrasound renal denervation to treat hypertension: the RADIANCE II randomized clinical trial. JAMA. 2023;329:651-661. 36853250.
854. Diagnostic Strategies for the Assessment of Suspected Stable Coronary Artery Disease : A Systematic Review and Meta-analysis.
作者: Andrea Zito.;Mattia Galli.;Giuseppe Biondi-Zoccai.;Antonio Abbate.;Pamela S Douglas.;Giuseppe Princi.;Domenico D'Amario.;Cristina Aurigemma.;Enrico Romagnoli.;Carlo Trani.;Francesco Burzotta.
来源: Ann Intern Med. 2023年176卷6期817-826页
There is uncertainty about which diagnostic strategy for detecting coronary artery disease (CAD) provides better outcomes.
855. Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial.
作者: Susan N Hastings.;Karen M Stechuchak.;Ashley Choate.;Courtney Harold Van Houtven.;Kelli D Allen.;Virginia Wang.;Cathleen Colón-Emeric.;George L Jackson.;Teresa M Damush.;Cassie Meyer.;Caitlin B Kappler.;Helen Hoenig.;Nina Sperber.;Cynthia J Coffman.
来源: Ann Intern Med. 2023年176卷6期743-750页
In trials, hospital walking programs have been shown to improve functional ability after discharge, but little evidence exists about their effectiveness under routine practice conditions.
856. Effectiveness of COVID-19 Treatment With Nirmatrelvir-Ritonavir or Molnupiravir Among U.S. Veterans: Target Trial Emulation Studies With One-Month and Six-Month Outcomes.
作者: Kristina L Bajema.;Kristin Berry.;Elani Streja.;Nallakkandi Rajeevan.;Yuli Li.;Pradeep Mutalik.;Lei Yan.;Francesca Cunningham.;Denise M Hynes.;Mazhgan Rowneki.;Amy Bohnert.;Edward J Boyko.;Theodore J Iwashyna.;Matthew L Maciejewski.;Thomas F Osborne.;Elizabeth M Viglianti.;Mihaela Aslan.;Grant D Huang.;George N Ioannou.
来源: Ann Intern Med. 2023年176卷6期807-816页
Information about the effectiveness of oral antivirals in preventing short- and long-term COVID-19-related outcomes in the setting of Omicron variant transmission and COVID-19 vaccination is limited.
857. In type 2 MI, the T2-risk score predicted death or MI at 1 y.
Taggart C, Monterrubio-Gómez K, Roos A, et al. Improving risk stratification for patients with type 2 myocardial infarction. J Am Coll Cardiol. 2023;81:156-168. 36631210.
858. Distributional Cost-Effectiveness of Equity-Enhancing Gene Therapy in Sickle Cell Disease in the United States.
作者: George Goshua.;Cecelia Calhoun.;Satoko Ito.;Lyndon P James.;Andrea Luviano.;Lakshmanan Krishnamurti.;Ankur Pandya.
来源: Ann Intern Med. 2023年176卷6期779-787页
Gene therapy is a potential cure for sickle cell disease (SCD). Conventional cost-effectiveness analysis (CEA) does not capture the effects of treatments on disparities in SCD, but distributional CEA (DCEA) uses equity weights to incorporate these considerations.
859. Comparison of Hospital Outcomes for Patients Treated by Allopathic Versus Osteopathic Hospitalists : An Observational Study.
作者: Atsushi Miyawaki.;Anupam B Jena.;Nate Gross.;Yusuke Tsugawa.
来源: Ann Intern Med. 2023年176卷6期798-806页
The United States has 2 types of degree programs that educate physicians: allopathic and osteopathic medical schools.
860. Association of Low-Dose Colchicine With Incidence of Knee and Hip Replacements : Exploratory Analyses From a Randomized, Controlled, Double-Blind Trial.
作者: Michelle W J Heijman.;Aernoud T L Fiolet.;Arend Mosterd.;Jan G P Tijssen.;Bart J F van den Bemt.;Astrid Schut.;John W Eikelboom.;Peter L Thompson.;Cornelia H M van den Ende.;Stefan M Nidorf.;Calin D Popa.;Jan H Cornel.
来源: Ann Intern Med. 2023年176卷6期737-742页
Osteoarthritis is a major contributor to pain and disability worldwide. Given that inflammation plays an important role in the development of osteoarthritis, anti-inflammatory drugs may slow disease progression.
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