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.

Glucagon-like peptide-1 receptor agonist (GLP-1RA) use has increased among women of reproductive age, but limited data exist on safety in pregnancy.

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.

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.

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

Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].

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

Emergency Med: [Formula: see text] Cardiology: [Formula: see text].

Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].

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

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

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.

GIM/FP/GP: [Formula: see text] Public Health: [Formula: see text].

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

GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text] Public Health: [Formula: see text].

Initiation of treatment with tirzepatide, a once-weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist (GLP-1RA), early after a diagnosis of type 2 diabetes (T2D) may establish better and more durable glycemic control than current treatment approaches per guidelines and clinical practice.

The growing involvement of private equity in the health care sector raises important questions about its effect on cost, quality, access, and the physician workforce. Private equity investment in health care is associated with increased costs and, in some settings, adverse effects on care delivery and outcomes. Rising costs, administrative burdens, workforce shortages, and declining reimbursement have made independent practice increasingly difficult, contributing to physician transitions to corporate ownership models. Physicians employed by private equity-owned health care organizations may also experience challenges due to the evolving dynamics of their work environment. State and federal regulators, as well as lawmakers, should consider implementing policy interventions to address these challenges. Although corporate investment may improve efficiency and, in limited instances, care delivery, private equity in this sector raises important questions about its role and effects. This American College of Physicians (ACP) position paper builds on the previous ACP position paper on financial profit in medicine, which explored the growing influence of corporate interests and private equity investment in the health care industry. This paper examines the effect of private equity investment on clinical autonomy, health care costs, quality, access, equity, and innovation. It emphasizes the need for more vigorous enforcement of regulatory measures and policy solutions to preserve the quality of patient care and protect the physician workforce. It also offers recommendations to strengthen oversight, transparency, and accountability related to private equity's effects on clinical autonomy, care delivery, and organizational decision making. Finally, it discusses the potential opportunities and challenges associated with private equity investment in health care, including increased consolidation and corporatization.

Medicare Advantage (MA), the private plan option within Medicare, now enrolls more than half of all beneficiaries and is projected to keep expanding. The American College of Physicians (ACP) assesses the ethical and policy dimensions of this growth and its implications for the delivery of fair, high-quality, and fiscally responsible care to older adults and persons with disabilities. Payment and risk adjustment policies have created vulnerabilities to overpayment and favorable risk selection, whereas quality measurement remains fragmented and overly complex. Beneficiaries often face challenges in navigating plan choice, marketing practices, prior authorization, and access to clinicians and postacute services, with these barriers disproportionately affecting persons with low income, persons with several chronic conditions, or persons who live in rural communities. Limited transparency about ownership structures and relationships between insurers, "provider" networks, and investors complicates accountability and public oversight. ACP calls for reforms to ensure accurate payment, streamline and strengthen quality metrics, and protect enrollees from inappropriate utilization controls while supporting innovations that promote coordinated, patient-centered care. Collaborative engagement among policymakers, clinicians, health systems, insurers, and beneficiaries is essential to align MA with its original purpose and ensure that it complements traditional Medicare while providing accessible, affordable, and high-quality coverage for all who depend on it.

Human health and natural systems are intrinsically linked-stable natural systems enable healthy human life. Health systems aim to promote, restore, and maintain health. Health systems may promote human health while having detrimental effects on natural systems, contributing to the transgression of planetary boundaries, such as biosphere integrity, climate change, and the introduction of new entities like microplastics. To date, the health guideline field lacks methods to assess the impacts of health interventions on planetary boundaries. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group established the Planetary Health Project Group in 2023 to develop formal GRADE guidance for integrating planetary health into guideline recommendations to address this gap. Guided by the concepts of planetary health and planetary boundaries and following established methods for GRADE guidance development, the project group conducted iterative case study analyses, expert workshops, and a 2-round global Delphi consensus process. Four case studies were selected for application of this guidance before recommendations were finalized. The GRADE Working Group approved the official guidance. The Planetary Health Project Group presents 7 domains of guidance for incorporating planetary health aspects into the guideline development process, including highly desirable items and optional items. Highly desirable items include formally addressing planetary health in public health and health system guidelines and explicitly justifying its exclusion where it is not addressed. Judgments within the evidence-to-decision (EtD) framework should systematically integrate included evidence across the prioritized planetary boundaries and equity. This guidance aims to support guideline developers and policymakers in making evidence-based, trustworthy recommendations to protect individual and planetary health, while maintaining thoroughness and feasibility for guideline developers within the GRADE approach.

Meta-analyses of randomized trials have shown that sigmoidoscopy screening reduces colorectal cancer (CRC) incidence and death for 15 years.