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1503. Breast Cancer Screening and Prevention.
Breast cancer is the most common cancer among U.S. women and its incidence increases with age. Endogenous estrogen exposure, proliferative benign breast disease, breast density, and family history may also indicate increased risk for breast cancer. Early detection with screening mammography reduces breast cancer mortality, but the net benefits vary by age. Assessing a patient's individual breast cancer risk can guide decisions regarding breast cancer screening. All women benefit from healthy behaviors which may reduce breast cancer risk. Some women at increased risk for breast cancer may benefit from risk-reducing medications. Use of screening measures remains suboptimal, especially for uninsured women.
1504. Rebound of COVID-19 With Nirmatrelvir-Ritonavir Antiviral Therapy.
In their article, Edelstein and colleagues provide the results of an observational study of virologic response in patients who received treatment with nirmatrelvir–ritonavir (N-R) versus those who received no COVID-19 therapy. The editorialists discuss the findings and emphasize the need for further consideration of the dosage, timing, and duration of treatment to inform optimal use of N-R.
1505. Efficacy of Acupuncture for Chronic Spontaneous Urticaria : A Randomized Controlled Trial.
作者: Hui Zheng.;Xian-Jun Xiao.;Yun-Zhou Shi.;Lei-Xiao Zhang.;Wei Cao.;Qian-Hua Zheng.;Feng Zhong.;Ping-Sheng Hao.;Ying Huang.;Ming-Ling Chen.;Wei Zhang.;Si-Yuan Zhou.;Yan-Jun Wang.;Chuan Wang.;Li Zhou.;Xiao-Qin Chen.;Zuo-Qin Yang.;Zi-Hao Zou.;Ling Zhao.;Fan-Rong Liang.;Ying Li.
来源: Ann Intern Med. 2023年176卷12期1617-1624页
The effectiveness of acupuncture for patients with chronic spontaneous urticaria (CSU), reported in a few small-scale studies, is not convincing.
1506. Impact of Clinical Demands on the Educational Mission in Hospital Medicine at 17 Academic Medical Centers : A Qualitative Analysis.
作者: Vishruti Patel.;Angela Keniston.;Lauren McBeth.;Sagarika Arogyaswamy.;Catherine Callister.;Khooshbu Dayton.;Neelam Mistry.;Sarah Mann.;Marisha Burden.
来源: Ann Intern Med. 2023年176卷11期1526-1535页
Clinical growth is outpacing the growth of traditional educational opportunities at academic medical centers (AMCs).
1507. SARS-CoV-2 Virologic Rebound With Nirmatrelvir-Ritonavir Therapy : An Observational Study.
作者: Gregory E Edelstein.;Julie Boucau.;Rockib Uddin.;Caitlin Marino.;May Y Liew.;Mamadou Barry.;Manish C Choudhary.;Rebecca F Gilbert.;Zahra Reynolds.;Yijia Li.;Dessie Tien.;Shruti Sagar.;Tammy D Vyas.;Yumeko Kawano.;Jeffrey A Sparks.;Sarah P Hammond.;Zachary Wallace.;Jatin M Vyas.;Amy K Barczak.;Jacob E Lemieux.;Jonathan Z Li.;Mark J Siedner.
来源: Ann Intern Med. 2023年176卷12期1577-1585页
Data are conflicting regarding an association between treatment of acute COVID-19 with nirmatrelvir-ritonavir (N-R) and virologic rebound (VR).
1511. Relationship Between Clinician Language and the Success of Behavioral Weight Loss Interventions : A Mixed-Methods Cohort Study.
作者: Charlotte Albury.;Helena Webb.;Elizabeth Stokoe.;Sue Ziebland.;Constantinos Koshiaris.;Joseph J Lee.;Paul Aveyard.
来源: Ann Intern Med. 2023年176卷11期1437-1447页
International guidelines recommend that primary care clinicians recognize obesity and offer treatment opportunistically, but there is little evidence on how clinicians can discuss weight and offer treatment in ways that are well received and effective.
1512. Colonoscopy-Ascertained Prevalence of Advanced Neoplasia According to Fecal Hemoglobin Concentration in a Large Cohort of Fecal Immunochemical Test-Negative Screening Participants.
作者: Tobias Niedermaier.;Thomas Heisser.;Rafael Cardoso.;Michael Hoffmeister.;Hermann Brenner.
来源: Ann Intern Med. 2023年176卷11期1569-1571页 1514. In ischemic LV dysfunction, adding PCI to medical therapy did not reduce a composite of death or aborted sudden death.
Perera D, Morgan HP, Ryan M, et al; REVIVED-BCIS2 Investigators. Arrhythmia and death following percutaneous revascularization in ischemic left ventricular dysfunction: prespecified analyses from the REVIVED-BCIS2 trial. Circulation. 2023;148:862-871. 37555345.
1515. In adults with BMI ≥27 kg/m2 and type 2 diabetes, adding tirzepatide to a lifestyle intervention increased weight loss at 72 wk.
Garvey WT, Frias JP, Jastreboff AM, et al; SURMOUNT-2 investigators. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2023;402:613-626. 37385275.
1516. In RA, use of systemic glucocorticoids ≥5 mg/d (prednisolone-equivalent) was linked to MACE at 8.7 y.
So H, Lam TO, Meng H, et al. Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: a population-based study. Ann Rheum Dis. 2023;82:1387-1393.37487608.
1517. In adults with HIV and low-to-moderate CV risk, pitavastatin reduced MACE over a median 5.1 y.
Grinspoon SK, Fitch KV, Zanni MV, et al; REPRIEVE Investigators. Pitavastatin to prevent cardiovascular disease in HIV infection. N Engl J Med. 2023;389:687-699. 37486775.
1518. Effects of Remote Patient Monitoring Use on Care Outcomes Among Medicare Patients With Hypertension : An Observational Study.
作者: Mitchell Tang.;Carter H Nakamoto.;Ariel D Stern.;Jose R Zubizarreta.;Felippe O Marcondes.;Lori Uscher-Pines.;Lee H Schwamm.;Ateev Mehrotra.
来源: Ann Intern Med. 2023年176卷11期1465-1475页
Remote patient monitoring (RPM) is a promising tool for improving chronic disease management. Use of RPM for hypertension monitoring is growing rapidly, raising concerns about increased spending. However, the effects of RPM are still unclear.
1519. In severe, uncontrolled asthma, tezepelumab reduced exacerbations over 1 y regardless of type 2 inflammation level.
Corren J, Menzies-Gow A, Chupp G, et al. Efficacy of tezepelumab in severe, uncontrolled asthma: pooled analysis of the PATHWAY and NAVIGATOR clinical trials. Am J Respir Crit Care Med. 2023;208:13-24. 37015033.
1520. In low-risk penicillin allergies, direct oral challenge was noninferior to skin testing followed by oral challenge.
Copaescu AM, Vogrin S, James F, et al. Efficacy of a clinical decision rule to enable direct oral challenge in patients with low-risk penicillin allergy: the PALACE randomized clinical trial. JAMA Intern Med. 2023;183:944-952. 37459086.
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