Annual review of medicinePub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1146/annurev-med-061523-021233
Emily F Eix, Jeniel E Nett
{"title":"<i>Candida auris</i>: Epidemiology and Antifungal Strategy.","authors":"Emily F Eix, Jeniel E Nett","doi":"10.1146/annurev-med-061523-021233","DOIUrl":"10.1146/annurev-med-061523-021233","url":null,"abstract":"<p><p><i>Candida auris</i> is a recently emerged fungal pathogen that causes severe infections in healthcare settings around the globe. A feature that distinguishes <i>C. auris</i> from other fungal pathogens is its high capacity to colonize skin, leading to widespread outbreaks in healthcare facilities via patient-to-patient transmission. <i>C. auris</i> can persist on skin or in the surrounding environment for extended periods of time, and it exhibits greater antifungal resistance than other <i>Candida</i> species. These factors pose major obstacles for the prevention and treatment of <i>C. auris</i> infection. Recent reports have identified frequently colonized skin sites, risk factors for developing invasive infection, and patterns of antifungal resistance among <i>C. auris</i> strains, all of which help guide therapeutic options. In this review, we highlight key studies of <i>C. auris</i> epidemiology and antifungal resistance, discussing how these factors influence healthcare-associated transmission and treatment outcomes.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"57-67"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annual review of medicinePub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1146/annurev-med-050522-034458
Lara Jehi
{"title":"Advances in Therapy for Refractory Epilepsy.","authors":"Lara Jehi","doi":"10.1146/annurev-med-050522-034458","DOIUrl":"10.1146/annurev-med-050522-034458","url":null,"abstract":"<p><p>Drug-resistant epilepsy (DRE) is defined as failure to achieve sustained seizure control with adequate trials of two appropriate antiseizure medications (ASMs). DRE affects one-third of patients with epilepsy and is associated with significant morbidity and mortality. Newer ASMs provide pharmacological therapy that is better tolerated but not necessarily more effective than older ASMs. Resective brain surgery is the gold standard to treat DRE and achieve seizure freedom, with laser ablation offering an alternative with less morbidity but lower effectiveness. For patients who are not candidates for resection or ablation, multiple neuromodulation options can reduce seizure burden. These neuromodulation devices have shown comparable effectiveness in randomized clinical trials, but the results vary in open-label follow-up cohorts, as do the risks of complications and associated costs. Dietary therapies can help, particularly in pediatric genetic epilepsies. Innovative genetic therapy approaches are being pursued, offering the promise of precision medicine.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"389-402"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613614","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}
Annual review of medicinePub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1146/annurev-med-050223-112834
Katarina Jankovic, Ian M Gralnek, Halim Awadie
{"title":"Emerging Long-Term Risks of the Use of Proton Pump Inhibitors and Potassium-Competitive Acid Blockers.","authors":"Katarina Jankovic, Ian M Gralnek, Halim Awadie","doi":"10.1146/annurev-med-050223-112834","DOIUrl":"10.1146/annurev-med-050223-112834","url":null,"abstract":"<p><p>Acid-related disorders represent a significant global health burden. Pharmacological treatment of these conditions has at times been challenged and limited by incomplete effectiveness, antibiotic resistance, adverse medication effects and/or interactions, and disease recurrence. Since the early 1990s, the mainstay of treatment has been proton pump inhibitors (PPIs). Recently, the US Food and Drug Administration issued a clearance for vonoprazan, a potassium-competitive acid blocker (PCAB). PCABs are a new class of acid-suppressing agents that may overcome some of these challenges. The aim of this review is to evaluate and compare the emerging long-term risks of PPI and PCAB therapies.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"143-153"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613615","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}
Annual review of medicinePub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1146/annurev-med-070323-103130
Seyni Gueye-Ndiaye, Susan Redline
{"title":"Sleep Health Disparities.","authors":"Seyni Gueye-Ndiaye, Susan Redline","doi":"10.1146/annurev-med-070323-103130","DOIUrl":"10.1146/annurev-med-070323-103130","url":null,"abstract":"<p><p>Sleep is an important and potentially modifiable determinant of many severe health outcomes. Sleep health disparities exist and are exemplified by reported differential rates of prevalence, severity, and outcomes among minority groups and low-socioeconomic-status backgrounds. In this review we highlight the concept of sleep health, review the evidence for disparities in sleep health, examine risk factors and consequences of poor sleep health, and discuss policy implications.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"403-415"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613619","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}
Annual review of medicinePub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1146/annurev-med-070623-045906
Peter D Zang, Arkhjamil Angeles, Sumanta K Pal
{"title":"CD70: An Emerging Anticancer Target in Renal Cell Carcinoma and Beyond.","authors":"Peter D Zang, Arkhjamil Angeles, Sumanta K Pal","doi":"10.1146/annurev-med-070623-045906","DOIUrl":"10.1146/annurev-med-070623-045906","url":null,"abstract":"<p><p>CD70 is an emerging target for anticancer therapies. It is an ideal antigen target given its limited expression in normal physiologic tissues and propensity to be aberrantly expressed in a variety of malignancies, thus limiting off-target toxicities. It is also heavily involved in immune homeostasis, and disruption of this pathway can help overcome tumor-related immune cell exhaustion. Recent phase I/II trials using cellular therapies targeting CD70, such as chimeric antigen receptor-T cells, have shown promising effectiveness and safety in treating relapsed or refractory renal cell carcinoma. Noncellular therapies targeting CD70, such as antibody-drug conjugates, monoclonal antibodies, radionuclides, and cytokines, are currently under investigation, with early data showing encouraging results as well. Efforts are already underway to further improve and optimize CD70-based therapies.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"257-266"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680580","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":"Hypertension Management in Pregnancy.","authors":"Kimberly Ryan, Lidija McGrath, Kathleen Brookfield","doi":"10.1146/annurev-med-050423-085626","DOIUrl":"10.1146/annurev-med-050423-085626","url":null,"abstract":"<p><p>Chronic hypertension and preeclampsia spectrum disorders in pregnancy are important contributors to long-term maternal morbidity and mortality. Due to physiologic changes during pregnancy and the postpartum period, blood pressure expectations differ between primary care providers and obstetricians. The goal of this article is to describe the pathophysiology and definitions of hypertension in the obstetric context and review current evidence for management during pregnancy and the postpartum period. Longitudinal follow-up with a primary care provider after delivery is crucial for long-term cardiovascular risk reduction in hypertensive patients.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"315-326"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715114","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":"Update on Hepatorenal Syndrome: From Pathophysiology to Treatment.","authors":"Saro Khemichian, Mitra K Nadim, Norah A Terrault","doi":"10.1146/annurev-med-050223-112947","DOIUrl":"10.1146/annurev-med-050223-112947","url":null,"abstract":"<p><p>Hepatorenal syndrome-acute kidney injury (HRS-AKI) occurs in the setting of advanced chronic liver disease, portal hypertension, and ascites. HRS-AKI is found in ∼20% of patients presenting to the hospital with AKI, but it may coexist with other causes of AKI and/or with preexisting chronic kidney disease, thereby making the diagnosis challenging. Novel biomarkers such as urinary neutrophil gelatinase-associated lipocalin may be useful. While HRS-AKI is a functional form of AKI related to circulatory and neurohormonal dysfunction, there is increasing recognition of the importance of systemic inflammation and the renal microenvironment. Early diagnosis and initiation of HRS-AKI-specific treatment can improve outcomes. The mainstay of therapy is a vasoconstrictor (terlipressin or norepinephrine) combined with albumin, which achieves resolution of HRS in 40-50% of cases. Liver transplantation is the only option for patients failing to respond to medical therapies.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":"76 1","pages":"373-387"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051411","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}
Cheríe S Blair, Mary Catherine Cambou, Raphael J Landovitz
{"title":"Update on HIV Chemoprevention.","authors":"Cheríe S Blair, Mary Catherine Cambou, Raphael J Landovitz","doi":"10.1146/annurev-med-042823-013707","DOIUrl":"10.1146/annurev-med-042823-013707","url":null,"abstract":"<p><p>Despite rapid advances in the field of HIV prevention and treatment, unacceptably high global HIV incidence rates highlight the ongoing need for effective HIV prevention interventions for populations at risk for HIV acquisition. This article provides an updated review of the current data surrounding HIV prevention strategies, including treatment as prevention (TasP), preexposure prophylaxis (PrEP), and postexposure prophylaxis (PEP), as well as advances in sexually transmitted infection biomedical prevention. This review provides an overview of the multiple PrEP modalities that are available globally, such as oral PrEP, injectable cabotegravir, and the dapivirine vaginal ring, and describes their respective clinical trials, efficacies, and regulatory approvals. We also discuss ongoing research into novel PrEP agents, such as broadly neutralizing antibodies, and efforts toward HIV vaccine development.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":"76 1","pages":"43-56"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057829","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}
Annual review of medicinePub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1146/annurev-med-060123-120109
Fady F Youssef, Laurel L Branch, Mark Kowalczyk, Thomas J Savides
{"title":"Endoscopic Approaches for Managing Small Intestinal Disease.","authors":"Fady F Youssef, Laurel L Branch, Mark Kowalczyk, Thomas J Savides","doi":"10.1146/annurev-med-060123-120109","DOIUrl":"10.1146/annurev-med-060123-120109","url":null,"abstract":"<p><p>The endoscopic evaluation and management of small intestinal diseases continue to evolve and expand. The advent of small bowel wireless capsule endoscopy and deep enteroscopy with either a double- or single-balloon enteroscope now allows complete endoscopic visualization of the entire small intestine and enables access for endoscopic interventions such as biopsies or hemostasis for most of the small bowel. New endoscopic techniques are available to treat proximal malignant small bowel obstruction, including intraluminal stents and endoscopic gastrojejunal stents. Emerging technologies also aim to improve weight loss and diabetes management via small bowel endoscopic interventions.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"155-165"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845673","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}
Annual review of medicinePub Date : 2025-01-01Epub Date: 2025-01-16DOI: 10.1146/annurev-med-050823-094312
James P Ho, William J Powers
{"title":"Contemporary Management of Acute Ischemic Stroke.","authors":"James P Ho, William J Powers","doi":"10.1146/annurev-med-050823-094312","DOIUrl":"10.1146/annurev-med-050823-094312","url":null,"abstract":"<p><p>In the past decade, adding mechanical thrombectomy (MT) of intracranial arterial occlusions to intravenous (IV) thrombolysis has revolutionized the treatment of acute ischemic stroke (AIS) by expanding the therapeutic window to 24 h. Treatment decisions require establishing a high probability of AIS; confirming time since last known well (LKW); assessing severity of the neurological deficit; determining any contraindications to IV thrombolysis; and performing neuroimaging, usually noncontrast computed tomography (NCCT), to exclude intracerebral hemorrhage. If time since LKW is less than 4.5 h, patients with disabling stroke without contraindications can proceed immediately to IV thrombolysis while the decision about MT is under way. For some patients, the MT decision can be made on the basis of clinical assessment, NCCT, and CT angiography showing a large vessel occlusion. Others may require additional neuroimaging. Patients who are not candidates for IV thrombolysis within 4.5 h or MT should be immediately evaluated for eligibility for extended-window IV thrombolysis or early antiplatelet treatment.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"417-429"},"PeriodicalIF":15.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574881","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}