The American journal of medicine
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During the past decade, growing recidivism has threatened the enormous beneficial impacts of vaccinations in the United States. The barriers are multifactorial and include increasing vaccine hesitancy. The continuing dedicated efforts of all healthcare professionals, along with advancements in vaccine technology and the resilience of public health systems, offers promise for the future. ⋯ Healthcare providers and public health officials should remain cognizant that increasing vaccination rates are essential but not sufficient. Surveillance containment entails rapid detection and reporting of cases with prompt immunization of household members and close contacts of confirmed cases, combined with judicious use of isolation, prompt antiviral or antibiotic medications, social distancing, respiratory etiquette, home or large-scale quarantines, and masking. The continuing and expanded efforts of US healthcare providers are vital to these successes.
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HIV remains a leading cause of death in the U.S. Previous research has examined mortality patterns among older adults with HIV, revealing regional and demographic disparities. This study aims to assess demographic and regional trends in HIV-related mortality among young adults from 1999 to 2020. ⋯ To address these disparities and ensure continued progress, urgent measures are required.
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This review addresses important issues that face practitioners today concerning the treatment of heart failure with preserved ejection fraction (HFpEF). It points out how the accepted efficacy of HFpEF medication treatment has changed. Medications are now recommended for use in HFpEF that have diuretic properties and are significant because of a reduction in the frequency of the development of heart failure (not mortality). ⋯ Chlorthalidone, possibly with a generic mineralocorticoid antagonist, could be an acceptable low-cost alternate therapy as secondary treatment for HFpEF. Of course, chlorthalidone does not have the other theoretic benefits of the sodium-glucose cotransporter 2 (SGLT2) inhibitors or finerenone. It would be helpful if this was discussed in the upcoming HFpEF guidelines, especially for use in patients who cannot afford or tolerate the new HFpEF medications.
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Hyperuricemia is a risk factor for cardiovascular disease complications in patients with chronic kidney disease. The impact of febuxostat on cardiovascular disease in advanced chronic kidney disease remains unclear. This study aimed to explore the cardiovascular benefits of xanthine oxidase inhibitors, particularly febuxostat and allopurinol, in patients with advanced chronic kidney disease. ⋯ Febuxostat may confer cardioprotective effects in patients with advanced chronic kidney disease compared with allopurinol, thereby making it potentially useful in reducing cardiovascular risks in this high-risk population.
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The aim of this study was to investigate the prevalence and type of complementary medicine (CM) use as well as potential factors related to CM use in a representative sample of US adults with self-reported post-COVID-19. ⋯ Our findings show a high prevalence of CM use among post-COVID-19 respondents, which highlights the need for further investigations on effectiveness, safety, and possible mechanisms of action.