GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].

GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Geriatrics: [Formula: see text].

GIM/FP/GP: [Formula: see text] Endocrinology: [Formula: see text].

Recent randomized controlled trials (RCTs) have investigated glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual or triple co-agonists for weight loss among adults with overweight or obesity and without diabetes.

GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].

GIM/FP/GP: [Formula: see text] Allerg & Immunol: [Formula: see text] Pulmonology: [Formula: see text].

In recognition of accelerating health care spending and alignment with the American College of Physicians (ACP) principles of promoting high-value care, the ACP Clinical Guidelines Committee (CGC) developed a framework to standardize its approach to identifying, appraising, and considering economic evidence in the development of ACP clinical guidelines. This article presents the CGC's process for incorporating economic evidence, which encompasses cost-effectiveness analyses, economic outcomes in randomized controlled trials, and resource utilization (intervention cost) data. Economic evidence is one component of ACP recommendations. The CGC first and foremost assesses the certainty of evidence for clinical net benefit of interventions; it then considers patient values and preferences, and only then considers economic evidence to develop recommendations.

Patient-provider communication through the patient portal has markedly increased in recent years. Some health care facilities implemented programs to enable providers to bill for responding to patient-initiated messages that require substantive medical decision making through an e-visit.

Reference tools are often uncritically accepted as balanced, objective, definitive, and evidence-based guides to medical knowledge. Yet for centuries textbooks and manuals have been entangled in various ways with industry interests. This essay shows how reference tools have served as sites of pharmaceutical promotion. Focusing on 2 reference tools, The Merck Manual and The Management of Pain, the authors sketch the complex and dynamic ways that Merck & Company and Purdue Frederick Company used medical reference texts to advance their market interests over the 20th century. Merck leveraged its eponymous Manual initially to promote its own products and later to elevate its brand name amid a public relations storm. Purdue's influence on pain medicine textbooks and prescribing manuals was less direct: By subsidizing the creation of pain medicine's flagship textbook and cultivating goodwill from key leaders, the company shaped the direction of many of the field's reference tools. As reference tools evolve over the 21st century, combining in new ways with machine-learning models, a historical perspective alerts us to the enduring influence, and vulnerabilities, of these aids to thought.

Reported results of clinical trials assessing higher-dose anticoagulation in patients hospitalized for COVID-19 have been inconsistent.

Yellow nail syndrome (YNS) is a rare disorder characterized by a triad of yellow dystrophic nails, lymphedema, and chronic lung disease. Most patients present in adulthood, with only a few congenital or familial cases described. The cause of YNS remains largely unknown, although defects in lymphatic vessel development are suggested to play a significant role.

Racial and ethnic disparities in health and health care persist in the United States, adversely affecting outcomes in prevention and treatment of chronic conditions among adults.

People with diabetes account for 25% of hospitalizations, or 8 million admissions annually. Poor glycemic control in the hospital is associated with increased morbidity, mortality, length of stay, and readmissions. Key considerations of inpatient diabetes management include initiation of appropriate insulin or medication regimens and frequent dose adjustments based on patient-specific factors. Inpatient diabetes management teams and new technologies are increasingly prevalent and can assist in achieving glycemic targets in the hospital. At discharge, standardized checklists should be used to ensure successful transitions of care.

Gastroesophageal reflux disease (GERD) is a common medical condition presenting with heartburn, regurgitation, cough, hoarseness, and/or wheezing. Patients with classic GERD symptoms often do not require diagnostic studies before empirical treatment is initiated. However, if atypical features are present, including alarm symptoms for malignancy, or if symptoms do not respond to conventional treatment, upper endoscopy may be necessary. The optimal management of GERD, which is the subject of debate, depends on the frequency and severity of symptoms. In 2021, the American College of Gastroenterology published updated recommendations for diagnosis and management of GERD. In addition to histamine-2 receptor antagonist or proton-pump inhibitor therapy, which may be prescribed as needed or continuously, lifestyle and dietary modification are often advised. Here, 2 physicians, a primary care practitioner and a gastroenterologist, debate how to manage a patient with GERD symptoms. They discuss the diagnosis of this condition, its initial management, indications for upper endoscopy, and how to care for the patient whose condition does not respond to empirical therapy.

Clinical risk calculators for coronary heart disease (CHD) do not include genetic, social, and lifestyle-psychological risk factors.

Anker SD, Friede T, von Bardeleben RS, et al; RESHAPE-HF2 Investigators. Transcatheter valve repair in heart failure with moderate to severe mitral regurgitation. N Engl J Med. 2024;391:1799-1809. 39216092.

Levy BT, Xu Y, Daly JM, et al. Comparative performance of common fecal immunochemical tests: a cross-sectional study. Ann Intern Med. 2024;177:1350-1360. 39222513.

Lønborg J, Jabbari R, Sabbah M, et al; NOTION-3 Study Group. PCI in patients undergoing transcatheter aortic-valve implantation. N Engl J Med. 2024 Aug 31. [Epub ahead of print.] 39216095.

Bajraktari G, Bytyçi I, Abdyli G, et al. One-month dual antiplatelet therapy reduces major bleeding compared with longer-term treatment without excess stent thrombosis: a systematic review and meta-analysis of randomized clinical trials. Am J Cardiol. 2024;227:91-97. 39029722.

Baldus S, Doenst T, Pfister R, et al; MATTERHORN Investigators. Transcatheter repair versus mitral-valve surgery for secondary mitral regurgitation. N Engl J Med. 2024;391:1787-1798. 39216093.