1881. First-Line Therapy for Type 2 Diabetes With Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists.
作者: Neda Laiteerapong.;Jason Alexander.;Louis Philipson.;Aaron N Winn.;Elbert S Huang.
来源: Ann Intern Med. 2023年176卷4期eL230007页 1887. Universal Masking in Health Care Settings: A Pandemic Strategy Whose Time Has Come and Gone, For Now.
作者: Erica S Shenoy.;Hilary M Babcock.;Karen B Brust.;Michael S Calderwood.;Shira Doron.;Anurag N Malani.;Sharon B Wright.;Westyn Branch-Elliman.
来源: Ann Intern Med. 2023年176卷6期859-861页
During the COVID-19 pandemic in the United States, the use of facemasks has been mandated in all health care settings for individuals older than 2 years, whether present as health care personnel, patients, or visitors. In this commentary, a group of health care epidemiologists, infectious diseases physicians, and researchers argue for the withdrawal of the universal masking policy given the current status of the COVID-19 pandemic.
1889. The New European Medical Device Regulation: Balancing Innovation and Patient Safety.
作者: Michael Bretthauer.;Sara Gerke.;Cesare Hassan.;Omer F Ahmad.;Yuichi Mori.
来源: Ann Intern Med. 2023年176卷6期844-848页
The European Union has introduced stricter provisions for medical devices under the new Medical Device Regulation (MDR). The MDR increases requirements for clinical trial testing for many devices before they can legally be placed on the market and extends requirements for rigorous clinical surveillance of benefits and harms to the entire life cycle of devices. New "expert panels" have been established by the European Commission to advise in the assessment of devices toward certification, and the role of previous "notified bodies" (private companies charged by the Commission with ensuring that manufacturers follow the requirements for device testing) is being expanded. The MDR does not contain a grandfathering clause; thus, all existing medical devices must be recertified under the stricter regulation. The recertification deadline has recently been extended to 2027 or 2028, depending on the device's risk class. Whether most device manufacturers can meet these new requirements is uncertain, and the MDR will likely have important consequences for manufacturers, researchers, clinicians, and patients. Enhanced collaborations between the medical device industry and physician partners will be needed to meet the new requirements in a timely manner to avoid shortages of existing devices and to mitigate barriers to development of new devices.
1892. Performance Measures for Physicians Providing Clinical Care Using Telemedicine: A Position Paper From the American College of Physicians.
作者: Amir Qaseem.;Catherine H MacLean.;Samantha Tierney.;J Thomas Cross.;Scott T MacDonald.;Caroline L Goldzweig.;Nick Fitterman.; .;Rebecca Andrews.;Peter Basch.;Suja M Mathew.;Robert M McLean.;Cristin A Mount.;Rhea E Powell.;Sameer D Saini.
来源: Ann Intern Med. 2023年176卷5期694-698页
There has been an exponential growth in the use of telemedicine services to provide clinical care, accelerated by the COVID-19 pandemic. Clinical care delivered via telemedicine has become a major and accepted method of health care delivery for many patients. There is an urgent need to understand quality of care in the telemedicine environment. This American College of Physicians position paper presents 6 recommendations to ensure the appropriate use of performance measures to evaluate quality of clinical care provided in the telemedicine environment.
1893. Long-Term Health Consequences After Ovarian Removal at Benign Hysterectomy : A Nationwide Cohort Study.
作者: Mathilde Gottschau.;Susanne Rosthøj.;Annette Settnes.;Gitte Lerche Aalborg.;Jakob Hansen Viuff.;Christian Munk.;Allan Jensen.;Susanne K Kjær.;Lene Mellemkjær.
来源: Ann Intern Med. 2023年176卷5期596-604页
More evidence is needed to substantiate current recommendations about removing ovaries during hysterectomy for benign conditions.
1895. Oral Fluvoxamine With Inhaled Budesonide for Treatment of Early-Onset COVID-19 : A Randomized Platform Trial.
作者: Gilmar Reis.;Eduardo Augusto Dos Santos Moreira Silva.;Daniela Carla Medeiros Silva.;Lehana Thabane.;Vitoria Helena de Souza Campos.;Thiago Santiago Ferreira.;Castilho Vitor Quirino Dos Santos.;Ana Maria Ribeiro Nogueira.;Ana Paula Figueiredo Guimaraes Almeida.;Leonardo Cançado Monteiro Savassi.;Adhemar Dias de Figueiredo Neto.;Carina Bitarães.;Aline Cruz Milagres.;Eduardo Diniz Callegari.;Maria Izabel Campos Simplicio.;Luciene Barra Ribeiro.;Rosemary Oliveira.;Ofir Harari.;Lindsay A Wilson.;Jamie I Forrest.;Hinda Ruton.;Sheila Sprague.;Paula McKay.;Christina M Guo.;Gordon H Guyatt.;Craig R Rayner.;David R Boulware.;Nicole Ezer.;Todd C Lee.;Emily Gibson McDonald.;Mona Bafadhel.;Christopher Butler.;Josue Rodrigues Silva.;Mark Dybul.;Edward J Mills.; .
来源: Ann Intern Med. 2023年176卷5期667-675页
Previous trials have demonstrated the effects of fluvoxamine alone and inhaled budesonide alone for prevention of disease progression among outpatients with COVID-19.
1896. Safety and Efficacy of Combination SARS-CoV-2 Neutralizing Monoclonal Antibodies Amubarvimab Plus Romlusevimab in Nonhospitalized Patients With COVID-19.
作者: Teresa H Evering.;Kara W Chew.;Mark J Giganti.;Carlee Moser.;Mauricio Pinilla.;David Alain Wohl.;Judith S Currier.;Joseph J Eron.;Arzhang Cyrus Javan.;Rachel Bender Ignacio.;David Margolis.;Qing Zhu.;Ji Ma.;Lijie Zhong.;Li Yan.;Ulises D'Andrea Nores.;Keila Hoover.;Bharat Mocherla.;Manish C Choudhary.;Rinki Deo.;Justin Ritz.;William A Fischer.;Courtney V Fletcher.;Jonathan Z Li.;Michael D Hughes.;Davey Smith.;Eric S Daar.; .
来源: Ann Intern Med. 2023年176卷5期658-666页
Development of safe and effective SARS-CoV-2 therapeutics is a high priority. Amubarvimab and romlusevimab are noncompeting anti-SARS-CoV-2 monoclonal antibodies with an extended half-life.
1899. How Would You Manage This Patient With Benign Prostatic Hyperplasia? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
作者: Gerald W Smetana.;C Christopher Smith.;Ajay Singla.;Howard Libman.
来源: Ann Intern Med. 2023年176卷4期545-555页
Lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) are common in older patients assigned male sex at birth, regardless of gender identity, and treatment of these symptoms is therefore common in primary care practice. In 2021, the American Urological Association published guidelines for management of BPH. They recommend using a standardized scoring system such as the International Prostate Symptom Score to help establish a diagnosis and to monitor the efficacy of interventions, α-blockers as the first-choice pharmacotherapy option, and 5α-reductase inhibitors for patients with prostate size estimated to be at least 30 cc. Tadalafil is another option regardless of erectile dysfunction. Combination therapies with α-blockers and 5α-reductase inhibitors, anticholinergic agents, or β3-agonists are effective options. A surgical referral is warranted if the BPH results in chronic kidney disease, refractory urinary retention, or recurrent urinary tract infections; if there is concern for bladder or prostate cancer; or if symptoms do not respond to medical therapy. In this article, a general internal medicine physician and a urologist discuss the treatment options and how they would apply their recommendations to a patient who wishes to learn more about his options.
1900. Periprocedural Anticoagulation.
Management of patients taking anticoagulants around the time of a procedure is a common and complex clinical scenario. Providing evidence-based care requires estimation of risk for thrombosis and bleeding, knowledge of commonly used medications, multidisciplinary communication and collaboration, and patient engagement and education. This review provides a standardized, evidence-based approach to periprocedural management of anticoagulation, based on current evidence and expert clinical guidelines.
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