Unhealthy alcohol use is common and includes severe alcohol use disorder. Screening tests identify patients who may benefit from preventive counseling, medications, or more intensive intervention.
Author: Alex H. Krist, Katharine A. Bradley
Posted: May 1, 2025, 12:00 am
This review considers enteral nutrition in the context of disease-related malnutrition, provides evidence for the use of enteral nutrition in hospitalized patients, and discusses practice considerations.
Author: Leah Gramlich, Peggi Guenter
Posted: April 17, 2025, 12:00 am
Few procedures have gone through a decade of practice-changing clinical trials as impressive as thrombectomy for stroke. Beginning in 2015 with multiple trials showing a benefit with thrombectomy in early large-vessel occlusion, followed by the extended-window trials in 2018 and then the large core trials in 2023, it seemed that...
Author: J Mocco
Posted: April 10, 2025, 12:00 am
With the aging of the population, aortic stenosis affects a growing number of patients, with a prevalence of 12.4% among persons who are at least 75 years of age, among whom 3.4% have severe aortic stenosis.1 Aortic stenosis is generally well tolerated for a prolonged period of time,...
Author: Ori Ben-Yehuda
Posted: April 10, 2025, 12:00 am
Among older patients undergoing TAVI, dapagliflozin led to a lower incidence of a composite of death from any cause or worsening of heart failure than standard care at 1 year.
Author: Sergio Raposeiras-Roubin, Ignacio J. Amat-Santos, Xavier Rossello, Rocío González Ferreiro, Inmaculada González Bermúdez, Diego Lopez Otero, Luis Nombela-Franco, Livia Gheorghe, Jose L. Diez, Carlos Baladrón Zorita, José A. Baz, Antonio J. Muñoz García, Victoria Vilalta, Soledad Ojeda-Pineda, José M. de la Torre Hernández, Juan G. Cordoba Soriano, Ander Regueiro, Pascual Bordes Siscar, Jorge Salgado Fernández, Bruno Garcia del Blanco, Roberto Martín-Reyes, Rafael Romaguera, César Moris, Sergio García Blas, Juan A. Franco-Peláez, Ignacio Cruz-González, Dabit Arzamendi, Nieves Romero Rodríguez, Felipe Díez-del Hoyo, Santiago Camacho Freire, Francisco Bosa Ojeda, Juan C. Astorga Burgo, Eduardo Molina Navarro, Juan Caballero Borrego, Valeriano Ruiz Quevedo, Ángel Sánchez-Recalde, Vicente Peral Disdier, Eduardo Alegría-Barrero, Javier Torres-Llergo, Gisela Feltes, José A. Fernández Díaz, Carlos Cuellas, Gustavo Jiménez Britez, Juan Sánchez-Rubio Lezcano, Cristina Barreiro-Pardal, Iván Núñez-Gil, Emad Abu-Assi, Andrés Iñiguez-Romo, Valentín Fuster, Borja Ibáñez, the DapaTAVI Investigators*
Posted: April 10, 2025, 12:00 am
In this trial involving 543 patients with stroke due to occlusion of medium or distal vessels, endovascular treatment within 24 hours after the onset of symptoms was not effective in improving functional outcome at 90 days.
Author: Marios Psychogios, Alex Brehm, Marc Ribo, Federica Rizzo, Daniel Strbian, Silja Räty, Juan F. Arenillas, Mario Martínez-Galdámez, Steven D. Hajdu, Patrik Michel, Jan Gralla, Eike I. Piechowiak, Daniel P.O. Kaiser, Volker Puetz, Frans Van den Bergh, Sylvie De Raedt, Flavio Bellante, Anne Dusart, Victoria Hellstern, Ali Khanafer, Guillermo Parrilla, Ana Morales, Jan S. Kirschke, Silke Wunderlich, Jens Fiehler, Götz Thomalla, Robin Lemmens, Jo P. Peluso, Manuel Bolognese, Alexander von Hessling, Adriaan van Es, Nyika D. Kruyt, Jonathan M. Coutinho, Carlos Castaño, Jens Minnerup, Wim van Zwam, Elisabeth Dhondt, Christian H. Nolte, Paolo Machi, Christian Loehr, Heinrich P. Mattle, Jan-Hendrik Buhk, Johannes Kaesmacher, Tomas Dobrocky, Panagiotis Papanagiotou, Angelika Alonso, Markus Holtmannspoetter, Andrea Zini, Leonardo Renieri, Fee Keil, Ido van den Wijngaard, Georg Kägi, Mikel Terceño, Martin Wiesmann, Sergio Amaro, Nikki Rommers, Luzia Balmer, Isabel Fragata, Mira Katan, Ronen R. Leker, Jeffrey L. Saver, Julie Staals, Urs Fischer, the DISTAL Investigators*
Posted: April 10, 2025, 12:00 am
In a trial involving patients with ischemic stroke due to medium-vessel occlusion, thrombectomy within 12 hours did not lead to a better functional outcome and lower mortality at 90 days than usual care.
Author: Mayank Goyal, Johanna M. Ospel, Aravind Ganesh, Dar Dowlatshahi, David Volders, Markus A. Möhlenbruch, Mouhammad A. Jumaa, Shahid M. Nimjee, Thomas C. Booth, Brian H. Buck, James Kennedy, Jai J. Shankar, Franziska Dorn, Liqun Zhang, Christian Hametner, Sandor Nardai, Atif Zafar, William Diprose, Shabnam Vatanpour, Alexander Stebner, Salome Bosshart, Nishita Singh, Ivy Sebastian, Kazutaka Uchida, Karla J. Ryckborst, Robert Fahed, Sherry X. Hu, Dominik F. Vollherbst, Syed F. Zaidi, Vivien H. Lee, Jeremy Lynch, Jeremy L. Rempel, Rachel Teal, Anurag Trivedi, Felix J. Bode, Ayokunle Ogungbemi, Mirko Pham, Peter Orosz, Mohamad Abdalkader, Christian Taschner, Jason Tarpley, Sven Poli, Ravinder-Jeet Singh, Reade De Leacy, George Lopez, Demetrios Sahlas, Michael Chen, Paul Burns, Joanna D. Schaafsma, Richard Marigold, Arno Reich, Adewumi Amole, Thalia S. Field, Richard H. Swartz, Fabio Settecase, Gábor Lenzsér, Santiago Ortega-Gutierrez, Negar Asdaghi, Kyriakos Lobotesis, Adnan H. Siddiqui, Joerg Berrouschot, Maxim Mokin, Koji Ebersole, Hauke Schneider, Albert J. Yoo, Jennifer Mandzia, Jesse Klostranec, Changez Jadun, Tufail Patankar, Eric Sauvageau, Robert Lenthall, Lissa Peeling, Thien Huynh, Ronald Budzik, Seon-Kyu Lee, Levansri Makalanda, Michael R. Levitt, Richard J. Perry, Thant Hlaing, Babak S. Jahromi, Paul Singh, Andrew M. Demchuk, Michael D. Hill, the ESCAPE-MeVO Investigators*
Posted: April 10, 2025, 12:00 am
Among U.S. and European adults, greater wealth was associated with lower mortality. The difference in mortality between the wealthiest and poorest appeared to be larger in the United States than in Europe.
Author: Sara Machado, Ilias Kyriopoulos, E. John Orav, Irene Papanicolas
Posted: April 3, 2025, 12:00 am
In patients with posterior circulation stroke for whom thrombectomy was not planned, alteplase administered 4.5 to 24 hours after stroke onset resulted in less disability at 90 days than standard treatment.
Author: Shenqiang Yan, Ying Zhou, Maarten G. Lansberg, David S. Liebeskind, Changzheng Yuan, Han Yu, Fujian Chen, Hongfang Chen, Bing Zhang, Lingqun Mao, Xiaoling Zhang, Xiaona Wang, Xuting Zhang, Yi Chen, Huan Zhou, Wansi Zhong, Yaode He, Kun Chen, Jianbing Wang, Hui Chen, Yuhui Huang, Bruce C.V. Campbell, Min Lou, the EXPECTS Group*
Posted: April 3, 2025, 12:00 am
In this randomized, placebo-controlled trial involving patients with giant-cell arteritis, the oral Janus kinase inhibitor upadacitinib (15 mg) significantly improved remission of disease, with less glucocorticoid use.
Author: Daniel Blockmans, Sara K. Penn, Arathi R. Setty, Wolfgang A. Schmidt, Andrea Rubbert-Roth, Ellen M. Hauge, Helen I. Keen, Tomonori Ishii, Nader Khalidi, Christian Dejaco, Maria C. Cid, Bernhard Hellmich, Meng Liu, Weihan Zhao, Ivan Lagunes, Ana B. Romero, Peter K. Wung, Peter A. Merkel, the SELECT-GCA Study Group*
Posted: April 2, 2025, 12:00 am
Having lost trust in physicians when he lost his daughter, a man with newly diagnosed cancer declines care, leaving the oncologist to consider past failures of communication, connection, and trust.
Author: Ranjana Srivastava
Posted: March 13, 2025, 12:00 am
Watching a patient’s family respond adversely to the stock communication tools an intern deploys, a palliative care consultant draws on her training in psychiatry to add nuance to those tools.
Author: Danielle Chammas
Posted: February 27, 2025, 12:00 am
Nonacute subdural hematoma is common among older persons. With an aging population and increasing use of antiplatelet and anticoagulant agents, subdural hematoma is projected to become the most common cranial neurosurgical disease by 2030.1 Standard treatments — including glucocorticoids and statins for milder cases, with the addition of...
Author: Peter Kan
Posted: February 27, 2025, 12:00 am
Medical, behavioral, and socio-structural factors contribute to poor health among people who are incarcerated. Health risks are magnified by conditions of confinement and lack of access to quality health care.
Author: Lauren Brinkley-Rubinstein, Justin Berk, Brie A. Williams
Posted: February 27, 2025, 12:00 am
Among patients receiving surgical or nonsurgical standard treatment for chronic subdural hematoma, adjunctive middle meningeal artery embolization reduced the risk of treatment failure within 180 days.
Author: David Fiorella, Stephen J. Monteith, Ricardo Hanel, Benjamin Atchie, SoHyun Boo, Ryan A. McTaggart, Alois Zauner, Stavropoula Tjoumakaris, Charlotte Barbier, Ronald Benitez, Laurent Spelle, Laurent Pierot, Joshua A. Hirsch, Michael Froehler, Adam S. Arthur, the STEM Investigators*
Posted: February 27, 2025, 12:00 am
When her mother asks for medical aid in dying, a neurointensivist and palliative care researcher finds herself torn between her doctorly response and her daughterly one, wavering in her convictions.
Author: Hannah Kirsch
Posted: February 13, 2025, 12:00 am
Roughly half the women who have reached menopause have fragility fractures.1 Such fractures impose major burdens, such as complications, cost, and death. A variety of effective therapies are available, yet in general they are underused.2 The risk of fracture increases as bone mineral density decreases; however,...
Author: Roland Chapurlat
Posted: January 16, 2025, 12:00 am
Zoledronate administered every 12 to 18 months prevents fractures in older women. Ten years after initiation of this trial, zoledronate administered at baseline and 5 years prevented vertebral fracture.
Author: Mark J. Bolland, Zaynah Nisa, Anna Mellar, Chiara Gasteiger, Veronica Pinel, Borislav Mihov, Sonja Bastin, Andrew Grey, Ian R. Reid, Greg Gamble, Anne Horne
Posted: January 16, 2025, 12:00 am
Making integrated fracture liaison services a routine part of postfracture care could help reduce disparities in care — and may offer a useful model for the management of other chronic diseases.
Author: Nicola Napoli, Peter R. Ebeling, Douglas P. Kiel
Posted: January 9, 2025, 12:00 am
Heart failure with preserved ejection fraction is noted for symptoms of heart failure, LVEF of at least 50%, and cardiac or structural abnormalities. Treatment includes diuretics and SGLT2 inhibitors.
Author: Antonio Cannata, Theresa A. McDonagh
Posted: January 9, 2025, 12:00 am