Annals of Internal Medicine最新文献

{"title":"Timing of Long COVID Improvement in Prospectively Followed RECOVER-Adult Participants.","authors":"Harrison T Reeder, Sarah E Donohue, Jeffrey N Martin, Mady Hornig, Jarrod M Mosier, Hassan Ashktorab, Ornina Atieh, Andra L Blomkalns, Hassan Brim, Yu Chen, Melissa M Cortez, Nathan B Erdmann, Meng Fang, Valerie J Flaherman, Paul Goepfert, Jason D Goldman, Naomi M Hamburg, Jenny E Han, James R Heath, Vanessa L Jacoby, Sarah E Jolley, J Daniel Kelly, Sara W Kelly, C Kim, Jerry A Krishnan, Rebecca J Letts, Emily B Levitan, Matthew E Modes, Grace A McComsey, Torri D Metz, Janet M Mullington, Igho Ofotokun, Megumi J Okumura, Claudia Castillo Paredes, Thomas F Patterson, Michael J Peluso, Rebecca Reece, Caitlin Ann Selvaggi, Zaki A Sherif, Hyagriv N Simhan, Upinder Singh, Barbara S Taylor, Brittany D Taylor, Tanayott Thaweethai, Joel D Trinity, Andrea B Troxel, Paul J Utz, Andrew J Vasey, Elisheva Weinberger, Zanthia Wiley, Juan P Wisnivesky, Lynn M Yee, Leora I Horwitz, Andrea S Foulkes, Bruce D Levy","doi":"10.7326/ANNALS-25-05275","DOIUrl":"10.7326/ANNALS-25-05275","url":null,"abstract":"<p><strong>Background: </strong>Long COVID (LC) is widespread; however, limited information has been reported on the likelihood that symptoms remit over time.</p><p><strong>Objective: </strong>To evaluate the likelihood of improvement among persons with likely LC.</p><p><strong>Design: </strong>Prospective, multisite cohort study (RECOVER-Adult [Researching COVID to Enhance Recovery]).</p><p><strong>Setting: </strong>83 U.S.-based sites across 33 states; Washington, DC; and Puerto Rico.</p><p><strong>Participants: </strong>1019 persons in RECOVER-Adult with likely LC (LC Research Index [LCRI] ≥11) 12 months after first SARS-CoV-2 infection.</p><p><strong>Measurements: </strong>The primary outcome was time until 2 consecutive study visits with LCRI less than 11. Secondary outcomes were time until LCRI measure reduced 50% or more and quality of life was good or better, and LCRI decreased to 0. Unadjusted estimates of cumulative incidence and adjusted marginal cumulative incidence by age, sex, SARS-CoV-2 wave, and LC subtype were reported across all follow-up time points.</p><p><strong>Results: </strong>An estimated 36.2% (95% CI, 33.0% to 39.5%) met the primary outcome by 24 months after infection, and 50.1% (CI, 46.1% to 54.0%) met the primary outcome by 36 months. An estimated 56.4% (CI, 52.2% to 60.4%) and 26.9% (CI, 23.3% to 30.5%), respectively, met the 2 secondary outcomes by 36 months. Among persons who still reported likely LC at 18 months and 24 months after first infection, relative timing of subsequent symptom improvement was similar.</p><p><strong>Limitation: </strong>Findings in this observational cohort are interpretable in a population with prevalent likely LC and do not address causal relationships between individual characteristics and symptom improvement.</p><p><strong>Conclusion: </strong>Among persons with likely LC 12 months after initial SARS-CoV-2 infection, one half experience meaningful reductions in symptoms by 36 months, whereas a quarter experience complete remission of symptoms. These findings underscore both the potential for natural recovery and the urgent need for placebo-controlled therapeutic intervention trials.</p><p><strong>Primary funding source: </strong>National Institutes of Health.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317281","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 elective cardiac surgery, perioperative dapagliflozin reduced acute kidney injury vs. placebo at 7 d.","authors":"Matthew T James, Ken Kuljit S Parhar","doi":"10.7326/ANNALS-26-04076-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-26-04076-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Nephrology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317265","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, combined SGLT2i + GLP-1 RA vs. either alone does not reduce MACE or renal outcomes.","authors":"Aviva Atri-Schuller, Victor M Montori","doi":"10.7326/ANNALS-26-04072-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-26-04072-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Endocrinology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317278","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":"After PCI in AF, DAT for 1 mo was noninferior to 12 mo for mortality or thromboembolic events and reduced major or nonmajor bleeding.","authors":"Debabrata Mukherjee","doi":"10.7326/ANNALS-26-04074-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-26-04074-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317257","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":"Decompression With or Without Fusion Across Subgroups With Degenerative Lumbar Spondylolisthesis : A Target Trial Emulation.","authors":"Harrison J Hansford, Bjørnar Berg, Margreth Grotle, Ivar M Austevoll, Issa J Dahabreh, Christian Hellum, Tor Ingebrigtsen, Matthew D Jones, Hopin Lee, Tore K Solberg, Kjersti Storheim, James H McAuley, Aidan G Cashin","doi":"10.7326/ANNALS-25-05260","DOIUrl":"https://doi.org/10.7326/ANNALS-25-05260","url":null,"abstract":"<p><strong>Background: </strong>Randomized trials have shown limited benefits and increased risks of adding spinal fusion surgery to decompression for degenerative spondylolisthesis. Decompression with fusion has increasingly been used in the United States.</p><p><strong>Objective: </strong>To examine the comparative effectiveness of decompression with fusion versus decompression alone for patient subgroups.</p><p><strong>Design: </strong>Cohort study using the target trial framework.</p><p><strong>Setting: </strong>Norwegian Registry for Spine Surgery and nested NORDSTEN-DS (Norwegian degenerative spondylolisthesis and spinal stenosis) randomized trial.</p><p><strong>Patients: </strong>Adults aged 18 to 80 years with lumbar degenerative spondylolisthesis and symptomatic back or leg pain lasting at least 3 months.</p><p><strong>Intervention: </strong>Lumbar spinal decompression surgery with fusion versus lumbar spinal decompression surgery alone.</p><p><strong>Measurements: </strong>The primary outcomes were Oswestry Disability Index (ODI) score and reoperation at 12 months. Linear regression models with inverse probability weighting to control for baseline confounding were used to obtain effect estimates with 95% CIs for decompression with fusion versus decompression alone for prespecified subgroups, including sex, age, smoking, body mass index (BMI), back pain intensity, and American Society of Anesthesiologists (ASA) grade.</p><p><strong>Results: </strong>Of 2252 patients, 236 were in the NORDSTEN-DS randomized trial. The mean age was 66 years, and 1576 (70%) women were included. A total of 1446 patients had decompression alone, and 806 had decompression with fusion; respective unadjusted baseline ODI scores were 38.9 (SD, 14.9) and 41.4 (SD, 14.7). At 12 months, the ODI score was 22.3 (95% CI, 15.5 to 29.1) for decompression alone and 20.0 (CI, 13.9 to 26.2) for decompression with fusion; the mean difference was 2.2 (CI, -1.6 to 6.1). In exploratory analyses, the ODI score was worse for decompression with fusion for men with BMI of 30 kg/m² or higher. Reoperation risk at 12 months did not differ.</p><p><strong>Limitation: </strong>Possible residual confounding.</p><p><strong>Conclusion: </strong>Patient subgroups did not have differential effects from the addition of fusion to decompression at 12 months.</p><p><strong>Primary funding source: </strong>Research Council of Norway.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317261","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":"Measles.","authors":"Nathan C Lo","doi":"10.7326/ANNALS-26-03912","DOIUrl":"https://doi.org/10.7326/ANNALS-26-03912","url":null,"abstract":"<p><p>Measles is reemerging, with cases and outbreaks increasing across the United States and other countries where measles had previously been eliminated. Most U.S. physicians have no experience with treating measles. However, the increasing likelihood of encountering not only children but also adults with measles requires a clinical review of the epidemiology, prevention, diagnosis, and management of this previously uncommon infection for general internal medicine physicians and hospitalists who care for adults in settings with measles reemergence. Prompt clinical suspicion, infection control measures, and notification of public health departments support timely diagnosis and disease control.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317279","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":"Use of GLP-1 RAs before or during pregnancy was not linked to maternal pregnancy complications.","authors":"Meera Jain, Liz Stephens","doi":"10.7326/ANNALS-26-03882-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-26-03882-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317282","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":"After successful catheter ablation in AF, discontinuing vs. continuing OAC reduces bleeding without increasing thromboembolic events.","authors":"Gregory Y H Lip","doi":"10.7326/ANNALS-26-03883-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-26-03883-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Hematology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317258","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":"Annals On Call - Artificial Intelligence: Risk, Accountability, and the Clinician's Role.","authors":"Robert M Centor, Andrew S Parsons","doi":"10.7326/ANNALS-26-04494-OC","DOIUrl":"https://doi.org/10.7326/ANNALS-26-04494-OC","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"e2604494OC"},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317259","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 intermediate-high-risk PE, adding catheter-directed thrombolysis to anticoagulation improved clinical outcomes at 7 d.","authors":"Joseph R Shaw, Nicola Potere","doi":"10.7326/ANNALS-26-04114-JC","DOIUrl":"https://doi.org/10.7326/ANNALS-26-04114-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Hematology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":17.2,"publicationDate":"2026-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149317266","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}