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4. How Would You Manage This Patient With Iron Deficiency Anemia? Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Iron deficiency anemia (IDA) is the most common cause of anemia worldwide and a major cause of disability, manifesting with symptoms including fatigue, weakness, exercise intolerance, worsening heart failure, impaired concentration, irritability, and depression. Women of reproductive age are disproportionately affected due to menstrual blood loss and gynecologic disorders. Iron deficiency anemia is diagnosed in patients who have both iron deficiency (ID), noted by low ferritin level and/or transferrin saturation, and anemia. Notably, iron deficiency (ID) can also occur in the absence of anemia, and overreliance on hemoglobin thresholds may risk missing the diagnosis in menstruating women due to flawed sex-specific reference ranges. Work-up for ID and IDA should focus on identifying the underlying cause of anemia, and may include a gynecologic work-up, bidirectional endoscopy, testing for Helicobacter pylori infection and celiac disease, as well as administering a trial of iron. Iron deficiency can be treated with either oral or intravenous iron. Although several guidelines address the diagnosis or management of ID and IDA, they differ in their recommendations based on the population studied, the clinical context, and the quality of the underlying evidence. Here, 2 hematologists and coauthors of the 2025 Iron Consortium Guideline published in Lancet Haematology discuss areas of guideline uncertainty relating to the diagnosis, evaluation, and treatment of patients with IDA and for Ms. B, a young woman diagnosed with ID.
6. Continuing Glucagon-Like Peptide-1 Receptor Agonists Into the First Trimester of Pregnancy and Pregnancy Outcomes : A Target Trial Emulation Study Using Claims Information.
作者: Jeremy P Brown.;Krista F Huybrechts.;Loreen Straub.;Elisabetta Patorno.;Ellen W Seely.;Brian T Bateman.;Sonia Hernández-Díaz.
来源: Ann Intern Med. 2026年
Glucagon-like peptide-1 receptor agonist (GLP-1RA) use has increased among women of reproductive age, but limited data exist on safety in pregnancy.
7. Estimating the Effect of Hospital Admission on Health Care Outcomes and Spending Among Persons With Dementia : A Quasi-experimental Study.
作者: Ryo Ikesu.;Elizabeth Rose Mayeda.;Kathleen McGarry.;Roch A Nianogo.;Christina M Ramirez.;Yusuke Tsugawa.
来源: Ann Intern Med. 2026年
Because transitions in care settings can be confusing for persons with dementia (PWD), hospital admissions can negatively affect their physical and cognitive function. However, the effect of hospital admissions on patient outcomes and health care spending remains largely unknown.
8. Hypertension.
Updated U.S. and international hypertension guidelines reflect new studies and analyses that support changes in hypertension management. The 2025 U.S. guideline for prevention, detection, evaluation, and management of high blood pressure (BP) recommends lower BP targets, greater use of out-of-office BP for diagnosis and medication titration, and a different approach to severe hypertension presenting without acute or evolving cardiovascular disease symptoms or signs. New treatments for resistant hypertension are recommended. Trial evidence supports benefit from tighter BP control to prevent mild cognitive impairment and dementia, further emphasizing the importance of lower BP goals.
13. In basilar artery occlusion, tenecteplase within 24 h of symptom onset improved functional outcome vs. usual care at 90 d.
Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].
14. In uncontrolled asthma, adding glycopyrronium to budesonide-formoterol reduced annualized severe exacerbations.
GIM/FP/GP: [Formula: see text] Allerg & Immunol: [Formula: see text] Pulmonology: [Formula: see text].
16. In adults with predisposing conditions, diagnostic accuracy of RCE components for detecting volume overload varies.
Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].
17. Statin therapy increased risk for 4 of 66 adverse outcomes listed in product labels compared with placebo at a median 4.5 y.
GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Endocrinology: [Formula: see text] Public Health: [Formula: see text].
19. The Sieve of Asclepius: A History of Navigating the Medical Literature, From Index to Algorithm.
For centuries, physicians have lamented the proliferating medical literature. This article traces the evolving strategies by which physicians have attempted to render this literature navigable for the purposes of research, teaching, and patient care. Beginning with John Shaw Billings' foundational indexing work at the Library of the Surgeon General's Office, the article examines successive (and overlapping) search regimes-including personal curation practices, abstract journals, pharmaceutical industry information services, citation indexing, and computerized retrieval systems-analyzing how each embedded value judgments about what counted as important or useful medical knowledge. Even as systems of search have evolved over time in conjunction with new technologic capabilities, business models, and search-related behavioral patterns, they have also grappled with enduring tensions between selectivity and comprehensiveness, between commercialism and scientific merit, and among the very boundaries of the conditions to be categorized and navigated. This history underscores how systems of search are not external maps of the knowledge ecosystem but are constitutive of it, influencing everything from journal rankings to research priorities to clinical practice. As literature search becomes integrated with artificial intelligence capabilities, a historical perspective helps physicians appreciate how such technologies condition what they know.
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