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Treatments for COVID-19. 治疗 COVID-19。
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2024-01-29 Epub Date: 2023-09-18 DOI: 10.1146/annurev-med-052422-020316
Hayden S Andrews, Jonathan D Herman, Rajesh T Gandhi
{"title":"Treatments for COVID-19.","authors":"Hayden S Andrews, Jonathan D Herman, Rajesh T Gandhi","doi":"10.1146/annurev-med-052422-020316","DOIUrl":"10.1146/annurev-med-052422-020316","url":null,"abstract":"<p><p>The treatment for COVID-19 has evolved rapidly since the start of the pandemic and now consists mainly of antiviral and immunomodulatory agents. Antivirals, such as remdesivir and nirmatrelvir-ritonavir, have proved to be most useful earlier in illness (e.g., as outpatient therapy) and for less severe disease. Immunomodulatory therapies, such as dexamethasone and interleukin-6 or Janus kinase inhibitors, are most useful in severe disease or critical illness. The role of anti-SARS-CoV-2 monoclonal antibodies has diminished because of the emergence of viral variants that are not anticipated to be susceptible to these treatments, and there still is not a consensus on the use of convalescent plasma. COVID-19 has been associated with increased rates of venous thromboembolism, but the role of antithrombotic therapy is limited. Multiple investigational agents continue to be studied, which will alter current treatment paradigms as new data are released.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"145-157"},"PeriodicalIF":10.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10656872","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}
引用次数: 0
Update on the Porphyrias. 卟啉症的最新进展
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2024-01-29 Epub Date: 2023-08-04 DOI: 10.1146/annurev-med-042921-123602
Amy K Dickey, Rebecca Karp Leaf, Manisha Balwani
{"title":"Update on the Porphyrias.","authors":"Amy K Dickey, Rebecca Karp Leaf, Manisha Balwani","doi":"10.1146/annurev-med-042921-123602","DOIUrl":"10.1146/annurev-med-042921-123602","url":null,"abstract":"<p><p>The porphyrias are a group of rare diseases, each resulting from a defect in a different enzymatic step of the heme biosynthetic pathway. They can be broadly divided into two categories, hepatic and erythropoietic porphyrias, depending on the primary site of accumulation of heme intermediates. These disorders are multisystemic with variable symptoms that can be encountered by physicians in any specialty. Here, we review the porphyrias and describe their clinical presentation, diagnosis, and management. We discuss novel therapies that are approved or in development. Early diagnosis is key for the appropriate management and prevention of long-term complications in these rare disorders.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"321-335"},"PeriodicalIF":10.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9942448","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}
引用次数: 0
Mpox: The Reemergence of an Old Disease and Inequities. 猴痘：旧病与不公平的重新融合。
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2024-01-29 Epub Date: 2023-10-03 DOI: 10.1146/annurev-med-080122-030714
J P Thornhill, M Gandhi, C Orkin
{"title":"Mpox: The Reemergence of an Old Disease and Inequities.","authors":"J P Thornhill, M Gandhi, C Orkin","doi":"10.1146/annurev-med-080122-030714","DOIUrl":"10.1146/annurev-med-080122-030714","url":null,"abstract":"<p><p>Mpox, previously known as monkeypox, is caused by an <i>Orthopoxvirus</i> related to the variola virus that causes smallpox. Prior to 2022, mpox was considered a zoonotic disease endemic to central and west Africa. Since May 2022, more than 86,000 cases of mpox from 110 countries have been identified across the world, predominantly in men who have sex with men, most often acquired through close physical contact or during sexual activity. The classical clinical presentation of mpox is a prodrome including fever, lethargy, and lymphadenopathy followed by a characteristic vesiculopustular rash. The recent 2022 outbreak included novel presentations of mpox with a predominance of anogenital lesions, mucosal lesions, and other features such as anorectal pain, proctitis, oropharyngeal lesions, tonsillitis, and multiphasic skin lesions. We describe the demographics and clinical spectrum of classical and novel mpox, outlining the potential complications and management.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"159-175"},"PeriodicalIF":10.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105561","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}
引用次数: 0
The Hospitalist Movement 25 Years Later. 25年后的住院医生运动。
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2024-01-29 Epub Date: 2023-10-06 DOI: 10.1146/annurev-med-051022-043301
Shradha A Kulkarni, Robert M Wachter
{"title":"The Hospitalist Movement 25 Years Later.","authors":"Shradha A Kulkarni, Robert M Wachter","doi":"10.1146/annurev-med-051022-043301","DOIUrl":"10.1146/annurev-med-051022-043301","url":null,"abstract":"<p><p>Hospitalists are generalists who specialize in the care of hospitalized patients. In the 25 years since the term hospitalist was coined, the field of hospital medicine has grown exponentially and established a substantial footprint in the medical community. There are now more hospitalists than practicing physicians in any other internal medicine subspecialty. Several key forces catalyzed the growth in the field of hospital medicine, including the quality, safety, and value movements; residency duty hour restrictions; the emergence of electronic health records; and the COVID-19 pandemic. Looking ahead, we see new opportunities in the realms of technology and telemedicine, and challenges persist in regard to balancing financial considerations with increasing workload and burnout. Hospitalists must remain nimble and seize emerging opportunities to continue supporting the field's prominence and growth.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"381-390"},"PeriodicalIF":10.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144999","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}
引用次数: 0
New Therapeutic Approaches to Large-Vessel Vasculitis. 大血管炎的新治疗方法
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2024-01-29 Epub Date: 2023-09-08 DOI: 10.1146/annurev-med-060622-100940
Mahmut S Kaymakci, Kenneth J Warrington, Tanaz A Kermani
{"title":"New Therapeutic Approaches to Large-Vessel Vasculitis.","authors":"Mahmut S Kaymakci, Kenneth J Warrington, Tanaz A Kermani","doi":"10.1146/annurev-med-060622-100940","DOIUrl":"10.1146/annurev-med-060622-100940","url":null,"abstract":"<p><p>Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are large-vessel vasculitides affecting the aorta and its branches. Arterial damage from these diseases may result in ischemic complications, aneurysms, and dissections. Despite their similarities, the management of GCA and TAK differs. Glucocorticoids are used frequently but relapses are common, and glucocorticoid toxicity contributes to significant morbidity. Conventional immunosuppressive therapies can be beneficial in TAK, though their role in the management of GCA remains unclear. Tumor necrosis factor inhibitors improve remission rates and appear to limit vascular damage in TAK; these agents are not beneficial in GCA. Tocilizumab is the first biologic glucocorticoid-sparing agent approved for use in GCA and also appears to be effective in TAK. A better understanding of the pathogenesis of both conditions and the availability of targeted therapies hold much promise for future management.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":" ","pages":"427-442"},"PeriodicalIF":10.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10557048","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}
引用次数: 0
Gender-Affirming Care of Transgender and Gender-Diverse Youth: Current Concepts. 变性和不同性别青少年的性别确认护理：当前的概念。
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2023-01-27 Epub Date: 2022-10-19 DOI: 10.1146/annurev-med-043021-032007
Janet Y Lee, Stephen M Rosenthal
{"title":"Gender-Affirming Care of Transgender and Gender-Diverse Youth: Current Concepts.","authors":"Janet Y Lee, Stephen M Rosenthal","doi":"10.1146/annurev-med-043021-032007","DOIUrl":"10.1146/annurev-med-043021-032007","url":null,"abstract":"<p><p>Increasing numbers of transgender and gender-diverse (TGD) youth, from early puberty through late adolescence, are seeking medical services to bring their physical sex characteristics into alignment with their gender identity-their inner sense of self as male or female or elsewhere on the gender spectrum. Numerous studies, primarily of short- and medium-term duration (up to 6 years), demonstrate the clearly beneficial-even lifesaving-mental health impact of gender-affirming medical care in TGD youth. However, there are significant gaps in knowledge and challenges to such care. Long-term safety and efficacy studies are needed to optimize medical care for TGD youth.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":"74 ","pages":"107-116"},"PeriodicalIF":10.5,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11045042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263280","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}
引用次数: 0
Cytokine Storm Syndrome. 细胞因子风暴综合征。
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2023-01-27 DOI: 10.1146/annurev-med-042921-112837
Randy Q Cron, Gaurav Goyal, W Winn Chatham
{"title":"Cytokine Storm Syndrome.","authors":"Randy Q Cron,&nbsp;Gaurav Goyal,&nbsp;W Winn Chatham","doi":"10.1146/annurev-med-042921-112837","DOIUrl":"https://doi.org/10.1146/annurev-med-042921-112837","url":null,"abstract":"<p><p>Cytokine storm syndrome (CSS), which is frequently fatal, has garnered increased attention with the ongoing coronavirus pandemic. A variety of hyperinflammatory conditions associated with multiorgan system failure can be lumped under the CSS umbrella, including familial hemophagocytic lymphohistiocytosis (HLH) and secondary HLH associated with infections, hematologic malignancies, and autoimmune and autoinflammatory disorders, in which case CSS is termed macrophage activation syndrome (MAS). Various classification and diagnostic CSS criteria exist and include clinical, laboratory, pathologic, and genetic features. Familial HLH results from cytolytic homozygous genetic defects in the perforin pathway employed by cytotoxic CD8 T lymphocytes and natural killer (NK) cells. Similarly, NK cell dysfunction is often present in secondary HLH and MAS, and heterozygous mutations in familial HLH genes are frequently present. Targeting overly active lymphocytes and macrophages with etoposide and glucocorticoids is the standard for treating HLH; however, more targeted and safer anticytokine (e.g., anti-interleukin-1, -6) approaches are gaining traction as effective alternatives.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":"74 ","pages":"321-337"},"PeriodicalIF":10.5,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10663763","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}
引用次数: 17
Regulation of Erythropoiesis by the Hypoxia-Inducible Factor Pathway: Effects of Genetic and Pharmacological Perturbations. 缺氧诱导因子途径对红细胞生成的调控:遗传和药理学扰动的影响。
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2023-01-27 DOI: 10.1146/annurev-med-042921-102602
Gregg L Semenza
{"title":"Regulation of Erythropoiesis by the Hypoxia-Inducible Factor Pathway: Effects of Genetic and Pharmacological Perturbations.","authors":"Gregg L Semenza","doi":"10.1146/annurev-med-042921-102602","DOIUrl":"https://doi.org/10.1146/annurev-med-042921-102602","url":null,"abstract":"<p><p>Red blood cells transport O<sub>2</sub> from the lungs to body tissues. Hypoxia stimulates kidney cells to secrete erythropoietin (EPO), which increases red cell mass. Hypoxia-inducible factors (HIFs) mediate <i>EPO</i> gene transcriptional activation. HIF-α subunits are subject to O<sub>2</sub>-dependent prolyl hydroxylation and then bound by the von Hippel-Lindau protein (VHL), which triggers their ubiquitination and proteasomal degradation. Mutations in the genes encoding EPO, EPO receptor, HIF-2α, prolyl hydroxylase domain protein 2 (PHD2), or VHL cause familial erythrocytosis. In addition to O<sub>2</sub>, α-ketoglutarate is a substrate for PHD2, and analogs of α-ketoglutarate inhibit hydroxylase activity. In phase III clinical trials evaluating the treatment of anemia in chronic kidney disease, HIF prolyl hydroxylase inhibitors were as efficacious as darbepoetin alfa in stimulating erythropoiesis. However, safety concerns have arisen that are focused on thromboembolism, which is also a phenotypic manifestation of VHL or HIF-2α mutation, suggesting that these events are on-target effects of HIF prolyl hydroxylase inhibitors.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":"74 ","pages":"307-319"},"PeriodicalIF":10.5,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10668530","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}
引用次数: 12
Primary Aldosteronism and the Role of Mineralocorticoid Receptor Antagonists for the Heart and Kidneys. 原发性醛固酮增多症和矿物质皮质激素受体拮抗剂对心脏和肾脏的作用。
IF 15.1 1区 医学
Annual review of medicine Pub Date : 2023-01-27 Epub Date: 2022-11-14 DOI: 10.1146/annurev-med-042921-100438
Jordana B Cohen, Irina Bancos, Jenifer M Brown, Harini Sarathy, Adina F Turcu, Debbie L Cohen
{"title":"Primary Aldosteronism and the Role of Mineralocorticoid Receptor Antagonists for the Heart and Kidneys.","authors":"Jordana B Cohen, Irina Bancos, Jenifer M Brown, Harini Sarathy, Adina F Turcu, Debbie L Cohen","doi":"10.1146/annurev-med-042921-100438","DOIUrl":"10.1146/annurev-med-042921-100438","url":null,"abstract":"<p><p>Primary aldosteronism (PA) is the most common cause of secondary hypertension but is frequently underrecognized and undertreated. Patients with PA are at a markedly increased risk for target organ damage to the heart and kidneys. While patients with unilateral PA can be treated surgically, many patients with PA are not eligible or willing to undergo surgery. Steroidal mineralocorticoid receptor antagonists (MRAs) are highly effective for treating PA and reducing the risk of target organ damage. However, steroidal MRAs are often underprescribed and can be poorly tolerated by some patients due to side effects. Nonsteroidal MRAs reduce adverse renal and cardiovascular outcomes among patients with diabetic kidney disease and are bettertolerated than steroidal MRAs. While their blood pressure-lowering effects remain unclear, these agents may have a potential role in reducing target organ damage in patients with PA.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":"74 ","pages":"217-230"},"PeriodicalIF":15.1,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9892285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10670069","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}
引用次数: 0
Update in Adult Transgender Medicine. 成人跨性别医学最新进展。
IF 10.5 1区 医学
Annual review of medicine Pub Date : 2023-01-27 DOI: 10.1146/annurev-med-020222-121106
Alyxandra Ramsay, Joshua D Safer
{"title":"Update in Adult Transgender Medicine.","authors":"Alyxandra Ramsay,&nbsp;Joshua D Safer","doi":"10.1146/annurev-med-020222-121106","DOIUrl":"https://doi.org/10.1146/annurev-med-020222-121106","url":null,"abstract":"<p><p>Transgender people often face barriers in health care due to lack of access to care, lack of knowledgeable healthcare professionals, discrimination, and gaps in medical and mental health research. Existing research on transgender health has focused heavily on mental health, HIV/AIDS, sexually transmitted diseases/infections, and substance abuse. Gender-affirming hormone therapy and/or surgery allows for some alignment of biology and gender identity. Gender-affirming care may offer quality-of-life benefits, which may outweigh modest concerns related to exogenous hormone therapy. The Endocrine Society treatment guidelines were revised in 2017, and this article reviews recent data that might inform a future guideline revision. Future longitudinal research is needed to close the gap in knowledge in the field of transgender medicine.</p>","PeriodicalId":8056,"journal":{"name":"Annual review of medicine","volume":"74 ","pages":"117-124"},"PeriodicalIF":10.5,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9241618","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}
引用次数: 1
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