34,494 results match your criteria Ann. Intern. Med.[Journal]


Serodiagnostics for Severe Acute Respiratory Syndrome-Related Coronavirus-2: A Narrative Review.

Ann Intern Med 2020 Jun 4. Epub 2020 Jun 4.

McGill Interdisciplinary Initiative in Infection and Immunity, School of Population and Global Health, McGill University, and Montreal Children's Hospital, Montreal, Quebec, Canada (J.P.).

Accurate serologic tests to detect host antibodies to severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) will be critical for the public health response to the coronavirus disease 2019 pandemic. Many use cases are envisaged, including complementing molecular methods for diagnosis of active disease and estimating immunity for individuals. At the population level, carefully designed seroepidemiologic studies will aid in the characterization of transmission dynamics and refinement of disease burden estimates and will provide insight into the kinetics of humoral immunity. Read More

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http://dx.doi.org/10.7326/M20-2854DOI Listing

Where Is the ID in COVID-19?

Ann Intern Med 2020 Jun 3. Epub 2020 Jun 3.

Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (R.P.W., J.D.G.).

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http://dx.doi.org/10.7326/M20-2684DOI Listing

Prevalence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review.

Ann Intern Med 2020 Jun 3. Epub 2020 Jun 3.

Scripps Research Translational Institute, Scripps Research, La Jolla, California (D.P.O., E.J.T.).

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world since the first cases of coronavirus disease 2019 (COVID-19) were observed in December 2019 in Wuhan, China. It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic, but their relative number and effect have been uncertain. The authors sought to review and synthesize the available evidence on asymptomatic SARS-CoV-2 infection. Read More

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http://dx.doi.org/10.7326/M20-3012DOI Listing

The Collision of COVID-19 and the U.S. Health System.

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

Oregon Health & Science University and Portland Veterans Affairs Medical Center, Portland, Oregon (T.G.C.).

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http://dx.doi.org/10.7326/M20-1851DOI Listing

A Sociotechnical Framework for Safety-Related Electronic Health Record Research Reporting: The SAFER Reporting Framework.

Ann Intern Med 2020 Jun;172(11_Supplement):S92-S100

University of Texas Memorial Hermann Center for Healthcare Quality & Safety, School of Biomedical Informatics, University of Texas Health Science Center at Houston, Texas (D.F.S.).

Electronic health record (EHR)-based interventions to improve patient safety are complex and sensitive to who, what, where, why, when, and how they are delivered. Success or failure depends not only on the characteristics and behaviors of individuals who are targeted by an intervention, but also on the technical characteristics of the intervention and the culture and environment of the health system that implements it. Current reporting guidelines do not capture the complexity of sociotechnical factors (technical and nontechnical factors, such as workflow and organizational issues) that confound or influence these interventions. Read More

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http://dx.doi.org/10.7326/M19-0879DOI Listing

Randomized Controlled Trials of Electronic Health Record Interventions: Design, Conduct, and Reporting Considerations.

Ann Intern Med 2020 Jun;172(11_Supplement):S85-S91

University of California, San Francisco, San Francisco, California (M.J.P., V.F., N.N., S.P., R.J.R., A.H., A.R., R.J.C., C.E.M., R.G., A.A.).

Electronic health record (EHR) systems can be configured to deliver novel EHR interventions that influence clinical decision making and to support efficient randomized controlled trials (RCTs) designed to evaluate the effectiveness, safety, and costs of those interventions. In designing RCTs of EHR interventions, one should carefully consider the unit of randomization (for example, patient, encounter, clinician, or clinical unit), balancing concerns about contamination of an intervention across randomization units within clusters (for example, patients within clinical units) against the superior control of measured and unmeasured confounders that comes with randomizing a larger number of units. One should also consider whether the key computational assessment components of the EHR intervention, such as a predictive algorithm used to target a subgroup for decision support, should occur before randomization (so that only 1 subgroup is randomized) or after randomization (including all subgroups). Read More

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http://dx.doi.org/10.7326/M19-0877DOI Listing

Getting Value From Electronic Health Records: Research Needed to Improve Practice.

Ann Intern Med 2020 Jun;172(11_Supplement):S130-S136

Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (D.W.B.).

Electronic health records (EHRs) are now widely adopted in the United States, but health systems have barely begun using them to deliver high-value care. More directed and rigorous research is needed to fulfill the promise of EHRs to not only store information but also support the delivery of better care. This article describes 4 potential benefits of EHR-based research: improving clinical decisions, supporting triage decisions, enabling collaboration among the care team (including patients), and increasing productivity via automation of tasks. Read More

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http://dx.doi.org/10.7326/M19-0878DOI Listing

Studying Workflow and Workarounds in Electronic Health Record-Supported Work to Improve Health System Performance.

Ann Intern Med 2020 Jun;172(11_Supplement):S116-S122

School of Medicine, University of California, San Francisco, San Francisco, California (J.A.).

Clinical workflow is the enactment of a series of steps to perform a clinical activity. The transition from paper to electronic health records (EHRs) over the past decade has been characterized by profound challenges supporting clinical workflow, impeding frontline clinicians' ability to deliver safe, efficient, and effective care. In response, there has been substantial effort to study clinical workflow as well as workarounds-exceptions to routine workflow-in order to identify opportunities for improvement. Read More

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http://dx.doi.org/10.7326/M19-0871DOI Listing

Reporting and Implementing Interventions Involving Machine Learning and Artificial Intelligence.

Ann Intern Med 2020 Jun;172(11_Supplement):S137-S144

Whiting School of Engineering, Baltimore, Maryland (P.S., S.S.).

Increasingly, interventions aimed at improving care are likely to use such technologies as machine learning and artificial intelligence. However, health care has been relatively late to adopt them. This article provides clinical examples in which machine learning and artificial intelligence are already in use in health care and appear to deliver benefit. Read More

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http://dx.doi.org/10.7326/M19-0872DOI Listing

Recommendations for the Conduct and Reporting of Research Involving Flexible Electronic Health Record-Based Interventions.

Ann Intern Med 2020 Jun;172(11_Supplement):S110-S115

Brigham and Women's Hospital, Boston, Massachusetts (N.K.C.).

In the past 2 decades, the United States has seen widespread adoption of electronic health records (EHRs) and a transition from mostly locally developed EHRs to commercial systems. However, most research on quality improvement and safety interventions in EHRs is still conducted at a single site, in a single EHR. Although single-site studies are important early in the innovation lifecycle, multisite studies of EHR interventions are critical for generalizability. Read More

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http://dx.doi.org/10.7326/M19-0880DOI Listing

Introduction: Improvement and Measurement in the Era of Electronic Health Records.

Ann Intern Med 2020 Jun;172(11_Supplement):S69-S72

Brigham and Women's Hospital, Boston, Massachusetts (D.W.B.).

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http://dx.doi.org/10.7326/M19-0870DOI Listing

Designing, Conducting, and Reporting Clinical Decision Support Studies: Recommendations and Call to Action.

Ann Intern Med 2020 Jun;172(11_Supplement):S101-S109

Lister Hill National Center for Biomedical Communications, National Library of Medicine, Bethesda, Maryland (C.J.M.).

By enabling more efficient and effective medical decision making, computer-based clinical decision support (CDS) could unlock widespread benefits from the significant investment in electronic health record (EHR) systems in the United States. Evidence from high-quality CDS studies is needed to enable and support this vision of CDS-facilitated care optimization, but limited guidance is available in the literature for designing and reporting CDS studies. To address this research gap, this article provides recommendations for designing, conducting, and reporting CDS studies to: 1) ensure that EHR data to inform the CDS are available; 2) choose decision rules that are consistent with local care processes; 3) target the right users and workflows; 4) make the CDS easy to access and use; 5) minimize the burden placed on users; 6) incorporate CDS success factors identified in the literature, in particular the automatic provision of CDS as a part of clinician workflow; 7) ensure that the CDS rules are adequately tested; 8) select meaningful evaluation measures; 9) use as rigorous a study design as is feasible; 10) think about how to deploy the CDS beyond the original host organization; 11) report the study in context; 12) help the audience understand why the intervention succeeded or failed; and 13) consider the financial implications. Read More

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http://dx.doi.org/10.7326/M19-0875DOI Listing

Using Electronic Health Record Portals to Improve Patient Engagement: Research Priorities and Best Practices.

Ann Intern Med 2020 Jun;172(11_Supplement):S123-S129

UCSF Department of Medicine, Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, California (C.R.L., A.G.C., U.S.).

Ninety percent of health care systems now offer patient portals to access electronic health records (EHRs) in the United States, but only 15% to 30% of patients use these platforms. Using PubMed, the authors identified 53 studies published from September 2013 to June 2019 that informed best practices and priorities for future research on patient engagement with EHR data through patient portals, These studies mostly involved outpatient settings and fell into 3 major categories: interventions to increase use of patient portals, usability testing of portal interfaces, and documentation of patient and clinician barriers to portal use. Interventions that used one-on-one patient training were associated with the highest portal use. Read More

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http://dx.doi.org/10.7326/M19-0876DOI Listing

Research and Reporting Considerations for Observational Studies Using Electronic Health Record Data.

Ann Intern Med 2020 Jun;172(11_Supplement):S79-S84

Division of Hospital Medicine, School of Medicine, Stanford University (J.H.C.).

Electronic health records (EHRs) are an increasingly important source of real-world health care data for observational research. Analyses of data collected for purposes other than research require careful consideration of data quality as well as the general research and reporting principles relevant to observational studies. The core principles for observational research in general also apply to observational research using EHR data, and these are well addressed in prior literature and guidelines. Read More

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http://dx.doi.org/10.7326/M19-0873DOI Listing

Context and Approach in Reporting Evaluations of Electronic Health Record-Based Implementation Projects.

Ann Intern Med 2020 Jun;172(11_Supplement):S73-S78

McMaster University, Hamilton, Ontario, Canada (R.B.H., A.I.).

Electronic health records (EHRs) are ubiquitous yet still evolving, resulting in a moving target for determining the effects of context (features of the work environment, such as organization, payment systems, user training, and roles) on EHR implementation projects. Electronic health records have become instrumental in effecting quality improvement innovations and providing data to evaluate them. However, reports of studies typically fail to provide adequate descriptions of contextual details to permit readers to apply the findings. Read More

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http://dx.doi.org/10.7326/M19-0874DOI Listing

Vasculitis: Again, Changing the Standard of Care.

Authors:
Gary S Hoffman

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

Cleveland Clinic, Cleveland, Ohio (G.S.H.).

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http://dx.doi.org/10.7326/M20-2853DOI Listing

Metabolic Alkalosis and Cystic Fibrosis: A Case Report.

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (S.G., M.S.).

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http://dx.doi.org/10.7326/L20-0038DOI Listing

The Challenges of Behavioral Health Integration: The Persistence of the Mind-Body Problem.

Authors:
Sue Bornstein

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

Texas Medical Home Initiative, Dallas, Texas (S.B.).

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http://dx.doi.org/10.7326/M20-2887DOI Listing

Factors Influencing Physician Practices' Adoption of Behavioral Health Integration in the United States: A Qualitative Study.

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

RAND Corporation, Santa Monica, California, and Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (M.W.F.).

Background: Behavioral health integration is uncommon among U.S. physician practices despite recent policy changes that may encourage its adoption. Read More

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http://dx.doi.org/10.7326/M20-0132DOI Listing

Web Exclusive. Annals Graphic Medicine - COVID Blues.

Authors:
Carla M Canepa

Ann Intern Med 2020 06 2. Epub 2020 Jun 2.

New York, New York (C.M.C.).

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http://dx.doi.org/10.7326/G20-0053DOI Listing

Web Exclusive. Annals Graphic Medicine - Masked Facies.

Authors:
Matthew S Krantz

Ann Intern Med 2020 06 2. Epub 2020 Jun 2.

Vanderbilt University Medical Center, Nashville, Tennessee (M.S.K.).

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http://dx.doi.org/10.7326/G20-0052DOI Listing

Long-Term Rituximab Use to Maintain Remission of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Randomized Trial.

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

Cochin Hospital, Paris Descartes University, Paris, France (P.C., C.V., X.P., B.T., L.M., L.G.).

Background: Biannual rituximab infusions over 18 months effectively maintain remission after a "standard" remission induction regimen for patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).

Objective: To evaluate the efficacy of prolonged rituximab therapy in preventing AAV relapses in patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) who have achieved complete remission after completing an 18-month maintenance regimen.

Design: Randomized controlled trial. Read More

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http://dx.doi.org/10.7326/M19-3827DOI Listing

Transparent Reporting of Multivariable Prediction Models in Journal and Conference Abstracts: TRIPOD for Abstracts.

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (P.H., J.B.R., J.A.D., R.J.S., K.G.M., L.H.).

Clear and informative reporting in titles and abstracts is essential to help readers and reviewers identify potentially relevant studies and decide whether to read the full text. Although the TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis) statement provides general recommendations for reporting titles and abstracts, more detailed guidance seems to be desirable. The authors present TRIPOD for Abstracts, a checklist and corresponding guidance for reporting prediction model studies in abstracts. Read More

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http://dx.doi.org/10.7326/M20-0193DOI Listing

COVID-19, Prison Visits, and the Value of a Cup of Coffee.

Authors:
Thomas J Doyle

Ann Intern Med 2020 Jun 2. Epub 2020 Jun 2.

Southcoast Health/Charlton Memorial Hospital, Fall River, Massachusetts (T.J.D.).

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http://dx.doi.org/10.7326/M20-3073DOI Listing

Systemic Lupus Erythematosus.

Ann Intern Med 2020 Jun;172(11):ITC81-ITC96

Thomas Jefferson University, Philadelphia, Pennsylvania (M.K., C.L.C.).

Systemic lupus erythematosus (lupus) is characterized by aberrant activity of the immune system, leading to variable clinical symptoms. Lupus is more prevalent in African American women and women in other ethnic minority groups. Diagnosing, treating, and identifying novel therapies for lupus is challenging because of its genetic and phenotypic heterogeneity. Read More

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http://dx.doi.org/10.7326/AITC202006020DOI Listing

Three (Not So) Easy Pieces.

Authors:
Donald R Bordley

Ann Intern Med 2020 Jun;172(11):763

University of Rochester, Rochester, New York (D.R.B.).

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http://dx.doi.org/10.7326/M20-0097DOI Listing

Bedside Optic Nerve Ultrasonography for Diagnosing Increased Intracranial Pressure.

Ann Intern Med 2020 Jun;172(11):771-772

University of Washington, Seattle, Washington (T.R., A.V., J.T.).

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http://dx.doi.org/10.7326/L20-0077DOI Listing

Bedside Optic Nerve Ultrasonography for Diagnosing Increased Intracranial Pressure.

Ann Intern Med 2020 Jun;172(11):772

McMaster University, Hamilton, Ontario, Canada (S.A.A.).

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http://dx.doi.org/10.7326/L20-0078DOI Listing

Patients With Opioid Use Disorder Deserve Trained Providers.

Ann Intern Med 2020 Jun;172(11):772-773

Massachusetts General Hospital, Boston, Massachusetts (S.E.W.).

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http://dx.doi.org/10.7326/L20-0081DOI Listing

Patients With Opioid Use Disorder Deserve Trained Providers.

Authors:
Richard Saitz

Ann Intern Med 2020 Jun;172(11):773

Boston University Schools of Public Health and Medicine and Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts (R.S.).

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http://dx.doi.org/10.7326/L20-0082DOI Listing

Patients With Opioid Use Disorder Deserve Trained Providers.

Ann Intern Med 2020 Jun;172(11):773-774

Johns Hopkins Hospital, Baltimore, Maryland (L.F.).

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http://dx.doi.org/10.7326/L20-0083DOI Listing

Patients With Opioid Use Disorder Deserve Trained Providers.

Ann Intern Med 2020 Jun;172(11):774-775

Yale School of Medicine, New Haven, Connecticut (M.B.W., J.M.T., D.A.F.).

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http://dx.doi.org/10.7326/L20-0084DOI Listing

Should You Recommend Inhaled Corticosteroids for This Patient With Chronic Obstructive Pulmonary Disease?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

Ann Intern Med 2020 Jun;172(11):735-742

Beth Israel Deaconess Medical Center, Boston, Massachusetts (R.B.B., A.A., M.B.R., G.W.S.).

Approximately 12 million adults in the United States receive a diagnosis of chronic obstructive pulmonary disease (COPD) each year, and it is the fourth leading cause of death. refers to a group of diseases that cause airflow obstruction and a constellation of symptoms, including cough, sputum production, and shortness of breath. The main risk factor for COPD is tobacco smoke, but other environmental exposures also may contribute. Read More

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http://dx.doi.org/10.7326/M20-1058DOI Listing

The Predictive Approaches to Treatment effect Heterogeneity (PATH) Statement.

Authors:
Stuart G Baker

Ann Intern Med 2020 Jun;172(11):775-776

National Cancer Institute, Bethesda, Maryland (S.G.B.).

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http://dx.doi.org/10.7326/L20-0426DOI Listing

The Predictive Approaches to Treatment effect Heterogeneity (PATH) Statement.

Ann Intern Med 2020 Jun;172(11):776

Tufts Medical Center, Boston, MA (D.M.K.).

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http://dx.doi.org/10.7326/L20-0427DOI Listing

Web Exclusive. Annals Graphic Medicine - Dr. Mom: PPE.

Authors:
Grace E Farris

Ann Intern Med 2020 06;172(11):W134-W135

Mount Sinai School of Medicine, New York, New York (G.E.F.).

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http://dx.doi.org/10.7326/G20-0042DOI Listing

Annals for Educators - 2 June 2020.

Ann Intern Med 2020 Jun;172(11):ED11

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http://dx.doi.org/10.7326/AWED202006020DOI Listing

Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review.

Ann Intern Med 2020 May 27. Epub 2020 May 27.

University of Connecticut Health Outcomes, Policy, and Evidence Synthesis Group and Hartford Hospital Department of Research Administration, Hartford, and School of Pharmacy, Storrs, Connecticut (C.M.W.).

Background: Hydroxychloroquine and chloroquine have antiviral effects in vitro against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2).

Purpose: To summarize evidence about the benefits and harms of hydroxychloroquine or chloroquine for the treatment or prophylaxis of coronavirus disease 2019 (COVID-19).

Data Sources: PubMed (via MEDLINE), EMBASE (via Ovid), Scopus, Web of Science, Cochrane Library, bioRxiv, Preprints, ClinicalTrials. Read More

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http://dx.doi.org/10.7326/M20-2496DOI Listing

Risk for COVID-19 Resurgence Related to Duration and Effectiveness of Physical Distancing in Ontario, Canada.

Ann Intern Med 2020 May 27. Epub 2020 May 27.

Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (A.R.T., D.N.F.).

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http://dx.doi.org/10.7326/M20-2945DOI Listing

Mental Health Treatment for Front-Line Clinicians During and After the Coronavirus Disease 2019 (COVID-19) Pandemic: A Plea to the Medical Community.

Ann Intern Med 2020 May 26. Epub 2020 May 26.

Vanderbilt University Medical Center and Research and Development, Veterans Affairs Tennessee Valley Health System, Nashville, Tennessee (J.U.B.).

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http://dx.doi.org/10.7326/M20-2440DOI Listing

Annals Graphic Medicine - Be Calm.

Authors:
Jesse Powell

Ann Intern Med 2020 Jun 26;172(11):W136-W139. Epub 2020 May 26.

Providence Portland Medical Center, Portland, Oregon (J.P.).

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http://dx.doi.org/10.7326/G19-0052DOI Listing

The Unrecognized Prevalence of Primary Aldosteronism.

Ann Intern Med 2020 May 26. Epub 2020 May 26.

Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.M.B., G.H.W., A.V.).

Background: Primary aldosteronism is a nonsuppressible renin-independent aldosterone production that causes hypertension and cardiovascular disease.

Objective: To characterize the prevalence of nonsuppressible renin-independent aldosterone production, as well as biochemically overt primary aldosteronism, in relation to blood pressure.

Design: Cross-sectional study. Read More

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http://dx.doi.org/10.7326/M20-0065DOI Listing

The Effect of Liraglutide on β-Blockade for Preventing Variceal Bleeding: A Case Series.

Ann Intern Med 2020 May 26. Epub 2020 May 26.

University of Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy (R.V., L.B., G.V., M.L.P., G.M., P.A.).

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http://dx.doi.org/10.7326/L20-0041DOI Listing

Long-Term Colorectal Cancer Incidence and Mortality After a Single Negative Screening Colonoscopy.

Ann Intern Med 2020 May 26. Epub 2020 May 26.

The Maria Sklodowska-Curie National Research Institute of Oncology and Medical Center for Postgraduate Education, Warsaw, Poland, and Institute of Health and Society, University of Oslo, Oslo, Norway (M.F.K.).

Background: Current guidelines recommend a 10-year interval between screening colonoscopies, but evidence is limited.

Objective: To assess the long-term risk for colorectal cancer (CRC) and death from CRC after a high- and low-quality single negative screening colonoscopy.

Design: Observational study. Read More

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http://dx.doi.org/10.7326/M19-2477DOI Listing

Primary Aldosteronism: At the Tipping Point.

Authors:
John W Funder

Ann Intern Med 2020 May 26. Epub 2020 May 26.

Hudson Institute of Medical Research, Wandin East, Victoria, Australia (J.W.F.).

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http://dx.doi.org/10.7326/M20-1758DOI Listing

Ventilation Techniques and Risk for Transmission of Coronavirus Disease, Including COVID-19: A Living Systematic Review of Multiple Streams of Evidence.

Ann Intern Med 2020 May 22. Epub 2020 May 22.

American University of Beirut Medical Center, Beirut, Lebanon (J.K., A.E., F.C., L.H., R.E., S.Y., Z.S., I.B.A., E.A.A.).

Background: Mechanical ventilation is used to treat respiratory failure in coronavirus disease 2019 (COVID-19).

Purpose: To review multiple streams of evidence regarding the benefits and harms of ventilation techniques for coronavirus infections, including that causing COVID-19. (PROSPERO registration: CRD42020178187). Read More

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http://dx.doi.org/10.7326/M20-2306DOI Listing
May 2020
17.810 Impact Factor