Sodium-glucose cotransporter-2 (SGLT2) inhibitors have the potential to alter the natural history of chronic kidney disease (CKD), and they should be included in cost-effectiveness analyses of screening for CKD.

This article summarizes the ACP/Annals COVID-19 Forum held on 19 May 2023.

Recently, validated clinical decision rules have been developed that avoid unnecessary use of computed tomographic pulmonary angiography (CTPA) in patients with suspected pulmonary embolism (PE) in the emergency department (ED).

The first 3 years of the COVID-19 pandemic witnessed an unprecedented pace of research that dramatically lessened morbidity and mortality due to COVID-19. This commentary discusses research findings that led to clinical practice recommendations that were later associated with excess mortality.

Measurement of the burden of COVID-19 on U.S. hospitals has been an important element of the public health response to the pandemic. However, because of variation in testing density and policies, the metric is not standardized across facilities. Two types of burdens exist, one related to the infection control measures that patients who test positive for SARS-CoV-2 require and one from the care of severely ill patients receiving treatment of COVID-19. With rising population immunity from vaccination and infection, as well as the availability of therapeutics, severity of illness has declined. Prior research showed that dexamethasone administration was highly correlated with other disease severity metrics and sensitive to the changing epidemiology associated with the emergence of immune-evasive variants. On 10 January 2022, the Massachusetts Department of Public Health began requiring hospitals to expand surveillance to include reports of both the total number of "COVID-19 hospitalizations" daily and the number of inpatients who received dexamethasone at any point during their hospital stay. All 68 acute care hospitals in Massachusetts submitted COVID-19 hospitalization and dexamethasone data daily to the Massachusetts Department of Public Health over a 1-year period. A total of 44 196 COVID-19 hospitalizations were recorded during 10 January 2022 to 9 January 2023, of which 34% were associated with dexamethasone administration. The proportion of patients hospitalized with COVID-19 who had received dexamethasone was 49.6% during the first month of surveillance and decreased to a monthly average of approximately 33% by April 2022, where it has remained since (range, 28.7% to 33%). Adding a single data element to mandated reporting to estimate the frequency of severe COVID-19 in hospitalized patients was feasible and provided actionable information for health authorities and policy makers. Updates to surveillance methods are necessary to match data collection with public health response needs.

Optimal use of masks for preventing COVID-19 is unclear.

The role of camp physicians of the Waffen-SS ("Armed SS," military branch of the Nazi Party's Schutzstaffel) in the implementation of the Holocaust has been the subject of limited research, even though they occupied a key position in the extermination process. From 1943 and 1944 onward, SS camp physicians made the individual medical decisions on whether each prisoner was fit for work or was immediately subjected to extermination, not only at the Auschwitz labor and extermination camp but also in pure labor camps like Buchenwald and Dachau. This was due to a functional change in the concentration camp system during World War II, where the selection of prisoners, which had previously been carried out by nonmedical SS camp staff, became a main task of the medical camp staff. The initiative to transfer sole responsibility for the selections came from the physicians themselves and was influenced by structural racism, sociobiologically oriented medical expertise, and pure economic rationality. It can be seen as a further radicalization of the decision making practiced until then in the murder of the sick. However, there was a far-reaching scope of action within the hierarchical structures of the Waffen-SS medical service on both the macro and micro levels. But what can this teach us for medical practice today? The historical experience of the Holocaust and Nazi medicine can provide a moral compass for physicians to be sensitive to the potential for abuse of power and ethical dilemmas inherent in medicine. Thus, the lessons from the Holocaust could be a starting point for reflecting on the value of human life in the modern economized and highly hierarchical medical sector.

As the COVID-19 public health emergency is lifted and the pandemic continues to recede, hospitals must decide how to deescalate mitigation strategies to sustainable states. This commentary advocates continuing universal masking in health care settings.

Excessive daytime sleepiness (EDS) is common among patients with obstructive sleep apnea (OSA). The comparative effectiveness of pharmacologic agents is unknown.

Blood and urine tests are commonly performed by clinicians in both ambulatory and hospital settings that detect chronic and acute kidney disease. Thresholds for these tests have been established that signal the presence and severity of kidney injury or dysfunction. In the appropriate clinical context of a patient's history and physical examination, an abnormal test result should trigger specific actions for clinicians, including reviewing patient medication use, follow-up testing, prescribing lifestyle modifications, and specialist referral. Tests for kidney disease can also be used to determine the future risk for kidney failure as well as cardiovascular death.

The cost-effectiveness of screening the U.S. population for Centers for Disease Control and Prevention (CDC) Tier 1 genomic conditions is unknown.

The effectiveness of glucagon-like peptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) in preventing major adverse cardiac events (MACE) is uncertain for those without preexisting cardiovascular disease.

The American Heart Association and American Stroke Association (AHA/ASA) endorsed 15 process measures for acute ischemic stroke (AIS) to improve the quality of care. Identifying the highest-value measures could reduce the administrative burden of quality measure adoption while retaining much of the value of quality improvement.

The recent mpox outbreak has disproportionately affected people with HIV (PWH) and resulted in the first widespread use of the novel antiviral tecovirimat. Whether treatment outcomes differ between PWH and those without HIV is unknown.

Qian HS, Li WJ, Dang YN, et al. Ten-day vonoprazan-amoxicillin dual therapy as a first-line treatment of Helicobacter pylori infection compared with bismuth-containing quadruple therapy. Am J Gastroenterol. 2023;118:627-634. 36729890.

Heyland DK, Patel J, Compher C, et al; EFFORT Protein Trial team. The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trial. Lancet. 2023;401:568-576. 36708732.

Major Extremity Trauma Research Consortium (METRC); O'Toole RV, Stein DM, O'Hara NN, et al. Aspirin or low-molecular-weight heparin for thromboprophylaxis after a fracture. N Engl J Med. 2023;388:203-213. 36652352.

McCarthy MW, Naggie S, Boulware DR, et al. Effect of fluvoxamine vs placebo on time to sustained recovery in outpatients with mild to moderate COVID-19: a randomized clinical trial. JAMA. 2023;329:296-305. 36633838.

McParland AL, Bhatia A, Matelski J, et al. Evaluating the impact of cannabinoids on sleep health and pain in patients with chronic neuropathic pain: a systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med. 2022;48:180-190. 36598058.

de Winter MA, Büller HR, Carrier M, et al; VTE-PREDICT study group. Recurrent venous thromboembolism and bleeding with extended anticoagulation: the VTE-PREDICT risk score. Eur Heart J. 2023;44:1231-1244. 36648242.