Annals of Internal Medicine最新文献

{"title":"The Interpretation of Dreams.","authors":"Jack Coulehan","doi":"10.7326/ANNALS-24-02443","DOIUrl":"https://doi.org/10.7326/ANNALS-24-02443","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":"178 7","pages":"1051"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635954","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":"Web Exclusive. Annals On Call - Diagnosing Primary Aldosteronism.","authors":"Robert M Centor, Jordana B Cohen","doi":"10.7326/ANNALS-25-03066-OC","DOIUrl":"https://doi.org/10.7326/ANNALS-25-03066-OC","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":"178 7","pages":"e2503066OC"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635959","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":"Does Anyone Remember the German Measles?","authors":"Bruce Farber","doi":"10.7326/ANNALS-25-01726","DOIUrl":"https://doi.org/10.7326/ANNALS-25-01726","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526154","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":"Rethinking Confirmatory Testing in Primary Aldosteronism.","authors":"Jordana B Cohen","doi":"10.7326/ANNALS-25-01368","DOIUrl":"10.7326/ANNALS-25-01368","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1044-1045"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962848","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 acute episodic migraine attacks, triptans, with or without NSAIDs, vs. NSAIDs alone reduce pain at 2 h and up to 48 h.","authors":"John R Absher","doi":"10.7326/ANNALS-25-02421-JC","DOIUrl":"10.7326/ANNALS-25-02421-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Neurology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"JC75"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526156","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":"High Frequency of Chronic Urticaria Following an Investigational HIV-1 BG505 MD39.3 Trimer mRNA Vaccine in a Phase 1, Randomized, Open-Label Clinical Trial (HVTN 302).","authors":"Sharon A Riddler, Zoe Moodie, Jesse Clark, Catherine Yen, Mary Allen, Briana D Furch, Huiyin Lu, Shannon Grant, Kajari Mondal, Maija Anderson, Janine Maenza, Maria P Lemos, Amanda S Woodward Davis, Stephen R Walsh, Magdalena E Sobieszczyk, Ian Frank, Paul Goepfert, Kathryn E Stephenson, Lindsey R Baden, Hong-Van Tieu, Michael C Keefer, M Juliana McElrath, James G Kublin, Lawrence Corey","doi":"10.7326/ANNALS-24-02701","DOIUrl":"10.7326/ANNALS-24-02701","url":null,"abstract":"<p><strong>Background: </strong>The mRNA platform is under investigation for many vaccines, including HIV-1 vaccines.</p><p><strong>Objective: </strong>To evaluate the safety and tolerability of 3 investigational HIV-1 trimer mRNA vaccines.</p><p><strong>Design: </strong>Safety analysis of mRNA vaccination in a phase 1, randomized, open-label trial. (ClinicalTrials.gov: NCT05217641).</p><p><strong>Setting: </strong>Ten research sites in the United States.</p><p><strong>Participants: </strong>108 volunteers aged 18 to 55 years without HIV-1.</p><p><strong>Intervention: </strong>Investigational HIV-1 BG505 MD39.3 trimer mRNA vaccines (gp140 soluble trimer, gp151 membrane-bound trimer, and gp151 CD4KO membrane-bound trimer) at doses of 100 and 250 mcg at 0, 2, and 6 months.</p><p><strong>Measurements: </strong>Solicited and unsolicited adverse reactions and events reported during the 12 months after the first vaccination.</p><p><strong>Results: </strong>Participants (<i>n</i> = 108) were randomly assigned to 6 vaccine groups. Mild to moderate local and systemic solicited events were common. Eighty participants reported 190 unsolicited adverse events (AEs); 30 were considered to be related to a study product. Most (73%) related AEs were mild, and the rest were moderate. Among related AEs, urticaria was reported by 7 of 108 participants (7% [95% CI, 3% to 13%]), 4 of whom had unresolved, intermittent urticaria at 12 months. In post hoc analyses, demographic characteristics, history of allergy or medication use, and COVID-19 were not associated with urticaria. In a comparison of participants with versus without urticaria, 100% (7 of 7; CI, 65% to 100%) versus 37% (37 of 101; CI, 28% to 46%) reported previous Moderna COVID-19 vaccination, 29% (2 of 7; CI, 8% to 64%) versus 76% (77 of 101; CI, 67% to 84%) reported previous Pfizer-BioNTech COVID-19 vaccination, and 0% (0 of 7; CI, 0% to 35%) versus 5% (5 of 101; CI, 2% to 11%) reported no previous mRNA COVID-19 vaccination.</p><p><strong>Limitations: </strong>Lack of a placebo group, open-label study, and post hoc evaluation of urticarial risk.</p><p><strong>Conclusion: </strong>Urticarial reactions associated with experimental HIV-1 mRNA vaccines were observed in this trial. Studies to investigate the mechanism and approaches to mitigate these reactions are underway to further advance HIV-1 vaccine research.</p><p><strong>Primary funding source: </strong>National Institutes of Health, National Institute of Allergy and Infectious Diseases.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"963-974"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966271","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":"Confirmatory Testing for Primary Aldosteronism : A Study of Diagnostic Test Accuracy.","authors":"Alexander A Leung, Raj S Padwal, Gregory L Hundemer, Erik Venos, David J T Campbell, Daniel T Holmes, Dennis J Orton, C Benny So, Stefan J Przybojewski, Cori E Caughlin, Janice L Pasieka, Doreen M Rabi, Gregory A Kline","doi":"10.7326/ANNALS-24-03153","DOIUrl":"10.7326/ANNALS-24-03153","url":null,"abstract":"<p><strong>Background: </strong>Confirmatory testing to verify the diagnosis of primary aldosteronism (PA) in patients who have an abnormal screening result is of uncertain benefit.</p><p><strong>Objective: </strong>To perform a blinded assessment of the seated saline suppression test (SSST).</p><p><strong>Design: </strong>Diagnostic test accuracy study. (ClinicalTrials.gov: NCT04422756).</p><p><strong>Setting: </strong>The regional Endocrine Hypertension Clinic in Calgary, Alberta, Canada.</p><p><strong>Participants: </strong>156 adults with a positive screening result for PA.</p><p><strong>Intervention: </strong>The SSST was done by administering 2 L of 0.9% sodium chloride intravenously over 4 hours with the patient seated.</p><p><strong>Measurements: </strong>Treatment response was considered the reference standard for determining disease status and was based on blood pressure lowering, reduction of antihypertensive drug dose, and normalization of biochemistry. Measures of diagnostic test accuracy, including sensitivity, specificity, positive predictive value, and negative predictive value, were estimated.</p><p><strong>Results: </strong>Post-SSST aldosterone concentrations measured using immunoassay overlapped between treatment responders (median, 329 pmol/L [IQR, 227 to 525 pmol/L]) and nonresponders (median, 255 pmol/L [IQR, 162 to 346 pmol/L]). The SSST could not discriminate between response statuses (area under the curve, 62.1% [95% CI, 45.1% to 79.1%]). The positive and negative likelihood ratios were equivocal for aldosterone cutoffs ranging from 140 to 300 pmol/L. These findings remained consistent after differences in treatment, occurrence of hypokalemia, and laboratory assay used were accounted for.</p><p><strong>Limitation: </strong>The study population had many patients with high-risk features of PA and few nonresponders.</p><p><strong>Conclusion: </strong>The SSST is associated with a high false-negative rate, and reliance on it may lead to missed opportunities for intervention.</p><p><strong>Primary funding source: </strong>The Canadian Institutes of Health Research, Hypertension Canada, and the Heart and Stroke Foundation of Canada.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"948-956"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952768","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":"Beyond the Check: Rethinking Unconditional Cash Transfers for Maternal Health Equity.","authors":"Joanne Constantin","doi":"10.7326/ANNALS-25-01462","DOIUrl":"10.7326/ANNALS-25-01462","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1048-1049"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148934","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":"To Hold or Not to Hold: Acing the Question of Perioperative Renin-Angiotensin-Aldosterone System Inhibitors.","authors":"Idalid Franco, Alexander F Arriaga","doi":"10.7326/ANNALS-25-01409","DOIUrl":"10.7326/ANNALS-25-01409","url":null,"abstract":"","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1038-1039"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207460","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 COVID-19 acute hypoxemic respiratory failure, awake prone positioning vs. supine positioning increases survival without intubation.","authors":"Erica Crosley, Greg S Martin","doi":"10.7326/ANNALS-25-02004-JC","DOIUrl":"10.7326/ANNALS-25-02004-JC","url":null,"abstract":"<p><strong>Clinical impact ratings: </strong>GIM/FP/GP: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"JC79"},"PeriodicalIF":19.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526159","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}