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Much ado over acetaminophen. 对乙酰氨基酚有很多麻烦。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-05214-IM
Stacey Butterfield
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引用次数: 0
Q&A: Commercial cannabis linked to more ED visits. 问答：商业大麻与急诊科就诊人数增加有关。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-05215-IM
Gianna Melillo
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引用次数: 0
2025 brought a bounty of sepsis research. 2025年出现了大量败血症研究。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-05448-IM
Stacey Butterfield
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引用次数: 0
Effectiveness of Sodium-Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists on Diabetic Foot Disease : An Emulated Target Trial. 钠-葡萄糖共转运蛋白-2抑制剂与胰高血糖素样肽-1受体激动剂治疗糖尿病足病的有效性：一项模拟靶点试验
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-01262
Frederik P B Kristensen, Diana H Christensen, Brian C Callaghan, Jens S Nielsen, Henning Andersen, Henrik T Sørensen, Reimar W Thomsen

Background: The effects of sodium-glucose cotransporter-2 inhibitors (SGLT-2is) on diabetic foot disease have been mixed in prior trials of SGLT-2is compared with placebo. The comparative risk for diabetic foot disease with SGLT-2is compared with glucagon-like peptide-1 receptor agonists (GLP-1RAs) is unknown.

Objective: To compare risks for foot disease in new users of SGLT-2is and GLP-1RAs.

Design: Cohort study using target trial emulation.

Setting: Danish population-based study.

Participants: Patients with type 2 diabetes initiating SGLT-2i or GLP-1RA treatment, identified using national health care registry data from 2013 to 2023, and a convenience sample enrolled in a research cohort study with additional behavioral and clinical assessments.

Measurements: Incident diagnosis of foot disease outcomes (peripheral neuropathy, peripheral artery disease, foot ulcers, or lower-limb amputation) as defined by the International Working Group on the Diabetic Foot. Inverse probability of treatment-weighted risk ratios (RRs) were estimated, with adjustment for 45 demographic, clinical, and other factors.

Results: The registry cohort included 53 769 new users of SGLT-2is and 30 380 of GLP-1RAs. During 6 years of follow-up, any foot disease occurred in 10.8% of SGLT-2i users and 12.0% of GLP-1RA users, corresponding to an RR of 0.90 (95% CI, 0.84 to 0.97) in an intention-to-treat analysis; differences did not emerge until after year 3, when 40% of SGLT-2i users and 32% of GLP-1RA users had discontinued initial treatment. The modest reduction in risk among SGLT-2i users was driven by lower risk for neuropathy (RR, 0.78 [CI, 0.68 to 0.87]). Users of SGLT-2is and GLP-1RAs had similar risks for peripheral artery disease, foot ulcers, amputations, and all-cause mortality.

Limitation: Residual confounding; exposure and outcome misclassification.

Conclusion: New SGLT-2i users had a modestly lower risk for foot disease largely driven by a lower risk for neuropathy than GLP-1RA users.

Primary funding source: Aarhus University and Center for Population Medicine.

背景：钠-葡萄糖共转运体-2抑制剂（SGLT-2is）对糖尿病足病的作用在之前的SGLT-2is与安慰剂的试验中一直是混合的。与胰高血糖素样肽-1受体激动剂（GLP-1RAs）相比，sglt -2与胰高血糖素样肽-1受体激动剂（GLP-1RAs）患糖尿病足病的比较风险尚不清楚。目的：比较SGLT-2is和GLP-1RAs新使用者发生足部疾病的风险。设计：采用目标试验模拟的队列研究。背景：丹麦人口为基础的研究。参与者：使用2013年至2023年国家卫生保健登记数据确定的2型糖尿病患者开始SGLT-2i或GLP-1RA治疗，以及一个方便的样本，纳入了一项具有额外行为和临床评估的研究队列研究。测量：根据国际糖尿病足工作组的定义，对足部疾病结局（周围神经病变、外周动脉疾病、足部溃疡或下肢截肢）的突发诊断。在对45个人口统计学、临床和其他因素进行调整后，估计治疗加权风险比（rr）的负概率。结果：注册队列包括53769名SGLT-2is新使用者和30380名GLP-1RAs新使用者。在6年的随访中，10.8%的SGLT-2i使用者和12.0%的GLP-1RA使用者发生足部疾病，在意向治疗分析中对应的RR为0.90 (95% CI， 0.84至0.97)；直到第三年后，当40%的SGLT-2i使用者和32%的GLP-1RA使用者停止初始治疗时，差异才出现。SGLT-2i使用者的风险适度降低是由于神经病变风险较低（RR, 0.78 [CI， 0.68至0.87]）。SGLT-2is和GLP-1RAs的使用者外周动脉疾病、足部溃疡、截肢和全因死亡率的风险相似。局限性：残留混淆；暴露和结果错误分类。结论：与GLP-1RA使用者相比，SGLT-2i新使用者患足部疾病的风险较低，这主要是由于神经病变的风险较低。主要资金来源：奥胡斯大学和人口医学中心。
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引用次数: 0
Q&A: Past challenges prop up today's politics around gender-affirming care. 问答：过去的挑战支撑了今天围绕性别肯定护理的政治。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-05446-IM
Ryan DuBosar
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引用次数: 0
In adults at high risk for ventricular arrhythmia, treatment to increase potassium to high-normal levels improved a composite outcome. 在室性心律失常高风险的成年人中，将钾增加到高正常水平的治疗改善了综合结果。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-04843-JC
Mohammed Ruzieh

Clinical impact ratings: GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].

临床影响评分：GIM/FP/GP:[公式：见文]心脏病学：[公式：见文]。
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引用次数: 0
In provoked VTE with ≥1 enduring risk factor, extending anticoagulation with apixaban reduced symptomatic recurrent VTE at 12 mo. 在持续性危险因素≥1的诱发性静脉血栓栓塞患者中，延长阿哌沙班抗凝治疗可减少症状性复发静脉血栓栓塞12个月。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-04963-JC
Andrew Dunn

Clinical impact ratings: GIM/FP/GP: [Formula: see text] Hematology: [Formula: see text].

临床影响评分：GIM/FP/GP:[公式：见文]血液学：[公式：见文]。
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引用次数: 0
GLP-1RAs increase risk for cholelithiasis and GERD but not other GI or biliary adverse events vs. placebo. 与安慰剂相比，GLP-1RAs增加了胆石症和胃食管反流的风险，但没有增加其他胃肠道或胆道不良事件的风险。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-05161-JC
Kelsey L Anderson, Joseph D Feuerstein

Clinical impact ratings: GIM/FP/GP: [Formula: see text] Endocrinology: [Formula: see text] Gastroenterology: [Formula: see text].

临床影响评分：GIM/FP/GP:[公式：见文]内分泌学：[公式：见文]胃肠病学：[公式：见文]。
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引用次数: 0
In adults hospitalized with acute HF, predischarge influenza vaccination reduced a composite of mortality or readmission at 1 y. 在因急性心衰住院的成人中，出院前接种流感疫苗可降低1岁时的死亡率或再入院率。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-04799-JC
Juan M Teran-Plasencia, Andre C Kalil

Clinical impact ratings: GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Infectious Disease: [Formula: see text].

临床影响评级：GIM/FP/GP:[公式：见文]心脏病学：[公式：见文]传染病：[公式：见文]。
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引用次数: 0
In older adults, RSV prefusion F vaccine reduced hospitalization for RSV-related respiratory tract disease vs. no vaccine. 在老年人中，与未接种相比，RSV预融合F疫苗减少了RSV相关呼吸道疾病的住院率。
IF 15.2 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine
Pub Date : 2026-01-06 DOI: 10.7326/ANNALS-25-05113-JC
Henry S Sacks

Clinical impact ratings: GIM/FP/GP: [Formula: see text] Geriatrics: [Formula: see text] Infectious Disease: [Formula: see text] Pulmonology: [Formula: see text].

临床影响评级：GIM/FP/GP:[公式：见文]老年病学：[公式：见文]传染病学：[公式：见文]肺病学：[公式：见文]。
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引用次数: 0
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