Annals of Internal Medicine最新文献

{"title":"Correction: 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline for the Management of Headache.","authors":"","doi":"10.7326/ANNALS-25-01555","DOIUrl":"10.7326/ANNALS-25-01555","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"908"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957623","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":"Diet and Risk for Incident Diverticulitis in Women : A Prospective Cohort Study.","authors":"Trevor Barlowe, Chelsea Anderson, Hazel B Nichols, Anna C Salvador, Robert S Sandler, Dale P Sandler, Anne F Peery","doi":"10.7326/ANNALS-24-03353","DOIUrl":"10.7326/ANNALS-24-03353","url":null,"abstract":"<p><strong>Background: </strong>Patients with diverticulitis often attempt to control their diet with a particular focus on avoiding nuts and seeds. However, whether dietary patterns or dietary intake of nuts and seeds are associated with diverticulitis risk is poorly studied, particularly in women.</p><p><strong>Objective: </strong>To determine whether select diets affect incident diverticulitis risk in women.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Cohort study in the United States and Puerto Rico.</p><p><strong>Participants: </strong>Women aged 35 to 74 years at enrollment who responded to food frequency and diverticulitis questionnaires and had no history of inflammatory bowel disease, cancer, or diverticulitis (<i>n</i> = 29 916).</p><p><strong>Intervention: </strong>Food frequency questionnaires were used to calculate dietary index scores and to assess intake of nuts, seeds, and corn.</p><p><strong>Measurements: </strong>Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHRs) and 95% CIs for the associations between each dietary component or dietary index and diverticulitis risk.</p><p><strong>Results: </strong>1531 cases of incident diverticulitis for 415 103 person-years of follow-up were identified. Intake of peanuts, nuts, and seeds (aHR,1.07 [95% CI, 0.91 to 1.25]) and fresh fruits with edible seeds (aHR,1.06 [CI, 0.90 to 1.24]) was not associated with incident diverticulitis. There was a reduced risk for incident diverticulitis in women in the highest quartile of healthy diets compared with the lowest quartile: the Dietary Approaches to Stop Hypertension diet (aHR, 0.77 [CI, 0.65 to 0.90]), the Healthy Eating Index (aHR, 0.78 [CI, 0.66 to 0.91]), the Alternative Healthy Eating Index (aHR, 0.81 [CI, 0.69 to 0.95]), and the Alternative Mediterranean diet (aHR, 0.91 [CI, 0.78 to 1.06]).</p><p><strong>Limitation: </strong>Confounding, selection bias, and measurement bias are possible.</p><p><strong>Conclusion: </strong>Healthy diets were associated with a reduced risk for incident diverticulitis in women. Consumption of nuts and seeds was not associated with diverticulitis risk.</p><p><strong>Primary funding source: </strong>National Institutes of Health.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"788-795"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959965","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":"SCCM made 4 conditional recommendations for managing symptoms in adults admitted to the ICU.","authors":"Brian Osorio, Irene Vargas, Saraschandra Vallabhajosyula","doi":"10.7326/ANNALS-25-01883-JC","DOIUrl":"10.7326/ANNALS-25-01883-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Critical Care: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"JC62"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207457","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 Graphic Medicine - Bold Buddies Stories.","authors":"Federico Muelas Romero","doi":"10.7326/ANNALS-25-00402-GM","DOIUrl":"10.7326/ANNALS-25-00402-GM","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"e2500402GM"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257162","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 for Educators - June 2025.","authors":"Christine Laine","doi":"10.7326/ANNALS-25-02545-ED","DOIUrl":"https://doi.org/10.7326/ANNALS-25-02545-ED","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":"178 6","pages":"e2502545ED"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309428","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":"Artificial Intelligence in the Provision of Health Care.","authors":"Matthew DeCamp, Lois Snyder Sulmasy","doi":"10.7326/ANNALS-24-03426","DOIUrl":"https://doi.org/10.7326/ANNALS-24-03426","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":"178 6","pages":"907"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309431","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 type 2 diabetes with CKD and additional CV risk factors, sotagliflozin reduced total MACE vs. placebo at a median 14 mo.","authors":"Aarti Thakkar, L Kristin Newby","doi":"10.7326/ANNALS-25-01791-JC","DOIUrl":"10.7326/ANNALS-25-01791-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Endocrinology: [Formula: see text] Nephrology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"JC67"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207453","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 active lupus nephritis, adding obinutuzumab to standard therapy increased complete renal response rates at 76 wk.","authors":"Amber O Molnar","doi":"10.7326/ANNALS-25-01947-JC","DOIUrl":"10.7326/ANNALS-25-01947-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Nephrology: [Formula: see text] Rheumatology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"JC68"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207450","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":"Risk for Stroke After Newly Diagnosed Atrial Fibrillation During Hospitalization for Other Primary Diagnoses : A Retrospective Cohort Study.","authors":"Husam Abdel-Qadir, Madison Gunn, Jiming Fang, Tomi Odugbemi, Irene Jeong, Peter C Austin, Paul Dorian, Cynthia A Jackevicius, Douglas S Lee, Sheldon M Singh, Karen Tu, Dennis T Ko","doi":"10.7326/ANNALS-24-01967","DOIUrl":"10.7326/ANNALS-24-01967","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) that is first diagnosed during hospitalization for other causes can subside with resolution of the inciting stressor.</p><p><strong>Objective: </strong>To describe the risk for stroke after newly diagnosed AF during hospitalization for other causes.</p><p><strong>Design: </strong>Population-based retrospective cohort study.</p><p><strong>Setting: </strong>Ontario, Canada.</p><p><strong>Participants: </strong>Patients aged 66 years or older discharged alive from the hospital between April 2013 and March 2023 with a first diagnosis of AF.</p><p><strong>Intervention: </strong>Newly diagnosed AF during hospitalization for other causes, categorized into cardiac medical, noncardiac medical, cardiac surgical, and noncardiac surgical.</p><p><strong>Measurements: </strong>The primary outcome was hospitalization for stroke. The cumulative incidence function was used to estimate crude incidence, censoring on anticoagulant dispensation. Inverse probability of censoring weights were used to account for informative censoring.</p><p><strong>Results: </strong>Atrial fibrillation was diagnosed in 20 639 patients (mean age, 77.1 years; 58.1% male) while hospitalized for other causes: 8340 (40.4%) for noncardiac medical, 7097 (34.4%) for cardiac surgical, 3553 (17.2%) for noncardiac surgical, and 1649 (8.0%) for cardiac medical diagnoses. At 1 year, anticoagulants were being dispensed to 26.4% of patients with CHA₂DS₂-VA scores of 1 to 4 and 35.2% of those with CHA₂DS₂-VA scores of 5 to 8. The 1-year risk for stroke without anticoagulation was 1.3% (95% CI, 0.7% to 2.3%) for cardiac medical, 1.2% (CI, 0.9% to 1.5%) for noncardiac medical, 1.1% (CI, 0.8% to 1.7%) for noncardiac surgical, and 1.0% (CI, 0.7% to 1.3%) for cardiac surgical patients. Patients with CHA₂DS₂-VA scores of 1 to 4 had a 1-year stroke risk of 0.7% (CI, 0.6% to 1.0%) without anticoagulation, compared with 1.8% (CI, 1.4% to 2.2%) at CHA₂DS₂-VA scores of 5 to 8.</p><p><strong>Limitation: </strong>Long-standing AF may have been misclassified as newly diagnosed, leading to overestimation of stroke risk.</p><p><strong>Conclusion: </strong>Among patients with newly diagnosed AF during hospitalization for other causes, a substantial proportion with low CHA₂DS₂-VA scores receive anticoagulation, with modest increases in this proportion at higher scores. The stroke risk in patients with CHA₂DS₂-VA scores greater than 4 approximated the 2% threshold commonly used to initiate anticoagulation in AF.</p><p><strong>Primary funding source: </strong>Canadian Cardiovascular Society.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"765-774"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957699","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":"Optimizing Ethical Care, Quality, and Safety in Long-Term Services and Supports: A Position Paper From the American College of Physicians.","authors":"Mark Aaron Unruh, Jan K Carney, Alejandro Moreno, Lois Snyder Sulmasy","doi":"10.7326/ANNALS-24-03641","DOIUrl":"10.7326/ANNALS-24-03641","url":null,"abstract":"<p><p>Long-term services and supports (LTSS) in the United States have faced substantial and enduring challenges. They encompass services for persons who can no longer independently care for themselves because of cognitive decline, functional limitations, chronic illness, or the sequelae of such conditions. These services are delivered in institutional and noninstitutional settings, such as nursing homes, assisted living facilities, and home- and community-based programs. This position paper by the American College of Physicians examines the ethical implications of current LTSS business models and practices and their effect on vulnerable persons receiving care in these settings. These models and practices include approaches to staffing, resource allocation, health equity, and attention to patient preferences and patient-centered care, as well as business strategies that focus on profit rather than patient care and ownership structures that can lack transparency and hinder accountability. Addressing these challenges necessitates a collaborative approach among policymakers, health care systems, researchers, physicians and other health care professionals, LTSS facility and agency owners, patients, and caregivers. By embracing shared goals through a collaborative approach, an LTSS system can be cultivated that optimizes ethical care, quality, and safety, ensuring respect for all individuals across their lifespan.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"839-846"},"PeriodicalIF":19.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962537","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}