Annals of Internal Medicine最新文献

{"title":"In symptomatic knee OA, adding oral methotrexate to usual analgesia reduced pain at 6 mo.","authors":"David S Pisetsky","doi":"10.7326/ANNALS-24-02769-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02769-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Kingsbury SR, Tharmanathan P, Keding A, et al. <b>Pain reduction with oral methotrexate in knee osteoarthritis: a randomized, placebo-controlled clinical trial.</b> Ann Intern Med. 2024;177:1145-1156. 39074374.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In HF, T2D, CKD, or atherosclerotic CVD, SGLT2 inhibitors reduce HF hospitalizations and CV mortality.","authors":"Doreen Zhu, William G Herrington","doi":"10.7326/ANNALS-24-02459-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02459-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Usman MS, Bhatt DL, Hameed I, et al. <b>Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis.</b> Lancet Diabetes Endocrinol. 2024;12:447-461. 38768620.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In T2D, SGLT-2 inhibitor effects on CV and kidney outcomes were consistent regardless of GLP-1 receptor agonist use.","authors":"Michelle Maher, Sean Dinneen","doi":"10.7326/ANNALS-24-02849-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02849-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Apperloo EM, Neuen BL, Fletcher RA, et al. <b>Efficacy and safety of SGLT2 inhibitors with and without glucagon-like peptide 1 receptor agonists: a SMART-C collaborative meta-analysis of randomised controlled trials.</b> Lancet Diabetes Endocrinol. 2024;12:545-557. 38991584.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Weight Loss Interventions on the Symptomatic Burden and Biomarkers of Polycystic Ovary Syndrome : A Systematic Review of Randomized Controlled Trials.","authors":"Jadine Scragg, Alice Hobson, Lia Willis, Kathryn S Taylor, Sharon Dixon, Susan A Jebb","doi":"10.7326/M23-3179","DOIUrl":"https://doi.org/10.7326/M23-3179","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is common in women of reproductive age and is associated with obesity. Clinical guidelines recommend weight loss, but the impact on the clinical manifestations of PCOS is unclear.</p><p><strong>Purpose: </strong>To quantify the effect of weight loss interventions on clinical features of PCOS, compared with usual care.</p><p><strong>Data sources: </strong>MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries were searched from inception through June 2024.</p><p><strong>Study selection: </strong>Randomized controlled trials comparing interventions aiming to reduce weight against usual care, including lower-intensity weight loss interventions in people with PCOS. Conversations with people with PCOS informed the outcomes.</p><p><strong>Data extraction: </strong>Pairs of independent reviewers screened studies, extracted data, and assessed risk of bias (RoB). Outcomes included glycemic control (Homeostasis Model Assessment for Insulin Resistance [HOMA-IR], fasting insulin and glucose), hormonal markers (free androgen index [FAI] and other sex hormones), menstrual frequency, hirsutism, and PCOS-related quality of life (QoL). Pooled mean differences were obtained from random-effects meta-analysis with Knapp-Hartung adjustment.</p><p><strong>Data synthesis: </strong>Primary analyses included 29 comparisons with 1529 participants: 13, 12, and 4 comparisons were judged as high, some, or low RoB, respectively. Twelve used behavioral interventions, 9 used glucagon-like peptide-1 (GLP1) agonists, and 8 used other weight loss medications. Weight loss interventions were associated with significantly greater improvements in HOMA-IR (mean difference, -0.45 [-0.75 to -0.15]; <i>I</i> ² = 24%), FAI (mean difference, -2.03 [-3.0 to -1.07]; <i>I</i> ² = 48%), and menstrual frequency (mean difference, 2.64 [0.65 to 4.63]; <i>I²</i>  = 43%). There was no evidence that weight loss interventions were associated with clinically or statistically significant improvements in hirsutism, QoL, or other sex hormones, which may be due to the limited power of the available data.</p><p><strong>Limitation: </strong>There was high statistical heterogeneity in the interventions, comparators, and outcomes, largely unexplained by sensitivity and subgroup analyses.</p><p><strong>Conclusion: </strong>Weight loss interventions were associated with improvements in some important features of PCOS and should be considered as a routine treatment option for people with PCOS.</p><p><strong>Primary funding source: </strong>National Institute for Health and Care Research School for Primary Care Research. (PROSPERO: CRD42022367488).</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring Safe Practice by Late Career Physicians: Institutional Policies and Implementation Experiences.","authors":"Andrew A White, Thomas H Gallagher, Paulina H Osinska, Daniel B Kramer, Kelly Davis Garrett, Michelle M Mello","doi":"10.7326/ANNALS-24-00829","DOIUrl":"https://doi.org/10.7326/ANNALS-24-00829","url":null,"abstract":"<p><strong>Background: </strong>Late career physicians (LCPs; physicians working beyond age 65 to 75 years) may be at higher risk for delivering unsafe care. To oversee LCPs, some health care organizations (HCOs) have adopted LCP policies requiring cognitive, physical, and practice performance screening assessments. Despite recent controversies, little is known about the content and implementation of such policies.</p><p><strong>Objective: </strong>To characterize key features of LCP policies and the perspectives of medical leaders responsible for policy development and implementation.</p><p><strong>Design: </strong>Mixed-methods study using content analysis and key informant interviews.</p><p><strong>Setting: </strong>29 U.S. HCOs with LCP policies active in 2020.</p><p><strong>Participants: </strong>21 purposively sampled interviewees in physician leadership roles at 18 HCOs.</p><p><strong>Measurements: </strong>Descriptive statistics of policy features and content analysis of interviews.</p><p><strong>Results: </strong>Although policies had many commonalities-mandatory universal screening at a trigger age around 70 years, a strategy of screening followed by in-depth assessment of positive results, and commitment to patient safety as the key motive-they varied substantially in the testing required, funding, processes after a positive screening result, and decision making around concerning results. Policies prioritized institutional discretion in interpreting and responding to test results; many lacked clear language about appeals or other procedural protections for physicians. Leaders were generally satisfied with policies but reported preemptive retirements as physicians approached the screening age and cautioned that substantial investment in cultivating physicians' buy-in was required for successful rollout.</p><p><strong>Limitations: </strong>Sampled policies and interviews may not be representative of all HCOs. The analysis excluded the experiences of HCOs that tried and failed to implement LCP screening.</p><p><strong>Conclusion: </strong>Policies about LCPs are considered successful by institutional leaders. Policy variations and early adopters' implementation experiences highlight opportunities to improve physician acceptance and program rigor.</p><p><strong>Primary funding source: </strong>The Greenwall Foundation.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients surviving COVID-19 had lower risk for long COVID in the Omicron vs. earlier eras.","authors":"Scott Selinger","doi":"10.7326/ANNALS-24-02441-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02441-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Xie Y, Choi T, Al-Aly Z. <b>Postacute sequelae of SARS-CoV-2 infection in the pre-Delta, Delta, and Omicron eras.</b> N Engl J Med. 2024;391:515-525. 39018527.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anonymous, on Another Beach.","authors":"Octavian C Ioachimescu","doi":"10.7326/ANNALS-24-01986","DOIUrl":"https://doi.org/10.7326/ANNALS-24-01986","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In adults with TBI and anemia, liberal vs. restrictive RBC transfusion did not reduce unfavorable neurologic outcomes by 10% at 6 mo.","authors":"Albahi Malik, Greg S Martin","doi":"10.7326/ANNALS-24-02456-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02456-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Turgeon AF, Fergusson DA, Clayton L, et al; HEMOTION Trial Investigators on behalf of the Canadian Critical Care Trials Group, the Canadian Perioperative Anesthesia Clinical Trials Group, and the Canadian Traumatic Brain Injury Research Consortium. <b>Liberal or restrictive transfusion strategy in patients with traumatic brain injury.</b> N Engl J Med. 2024;391:722-735. 38869931.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In older inpatients with polypharmacy, medication optimization did not improve outcomes at 48 wk.","authors":"Jacob A Lebin, Elizabeth Goldberg","doi":"10.7326/ANNALS-24-02771-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02771-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Ie K, Hirose M, Sakai T, et al. <b>Medication optimization protocol efficacy for geriatric inpatients: a randomized clinical trial.</b> JAMA Netw Open. 2024;7:e2423544. 39078632.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In adults with BMI ≥27 kg/m² and CVD, but without diabetes, semaglutide reduced MACE, regardless of baseline HbA_1c level.","authors":"Doreen Zhu, William G Herrington","doi":"10.7326/ANNALS-24-02457-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02457-JC","url":null,"abstract":"<p><strong>Source citation: </strong>Lingvay I, Deanfield J, Kahn SE, et al; SELECT Trial Investigators. <b>Semaglutide and cardiovascular outcomes by baseline HbA_1c and change in HbA_1c in people with overweight or obesity but without diabetes in SELECT.</b> Diabetes Care. 2024;47:1360-1369. 38907684.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}