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Isam Atroshi, MD, PhD; Magnus Flondell, MD; Manfred Hofer, BSc; and Jonas Ranstam, PhD

Steroid injections are often used to alleviate symptoms of the carpal tunnel syndrome (CTS) and prevent the need for surgery. This trial randomly assigned patients with mild to moderate CTS who were unsuccessfully treated with wrist splinting to 1 of 2 doses of methylprednisolone or placebo. The methylprednisolone recipients were somewhat less likely to have had surgery at the 1-year follow-up than the placebo recipients, but 3 out of 4 of them did have surgery within 1 year. In most patients with CTS, methylprednisolone temporarily improves symptoms but does not obviate the need for surgery.

Topics: adrenal corticosteroids, carpal tunnel syndrome, methylprednisolone, steroids, corticosteroid injections, local
  
Sean D. Young, PhD, MS; William G. Cumberland, PhD; Sung-Jae Lee, PhD; Devan Jaganath, MPH; Greg Szekeres, BA; and Thomas Coates, PhD

HIV infection is a major health concern for men who have sex with men (MSM). Because social media use is high in this population, it may be a tool for HIV education and intervention. In this trial of a peer-led HIV education intervention delivered through social media (Facebook), MSM in the intervention group were more likely to request, complete, and return home HIV testing kits than were those in the control group. They indicated high satisfaction, engagement, and retention with the intervention. Social media may be effective for HIV prevention and diagnosis in MSM.

Topics: hiv screen, hiv prevention, social networking, men who have sex with men, ...
  
Edmund S. Cibas, MD; Zubair W. Baloch, MD, PhD; Giovanni Fellegara, MD; Virginia A. LiVolsi, MD; Stephen S. Raab, MD; Juan Rosai, MD; James Diggans, PhD; Lyssa Friedman, RN, MPA; Giulia C. Kennedy, PhD; Richard T. Kloos, MD; Richard B. Lanman, MD; Susan J. Mandel, MD, MPH; Nicole Sindy, MBS; David L. Steward, MD; Martha A. Zeiger, MD; Bryan R. Haugen, MD; and Erik K. Alexander, MD

Clinical management of thyroid neoplasms is often based on light microscopic diagnosis. This multicenter study examined concordance between preoperative cytopathologic and postoperative histopathologic thyroid diagnoses made by local pathologists versus those made by independent central expert panelists. Local versus central cytopathology and histopathology diagnoses were concordant in 64% and 91% of cases, respectively. Intraobserver concordance for diagnoses made by central cytopathologists and histopathologists were 75% and 90%, respectively, and central cytopathologists made fewer indeterminate diagnoses than local pathologists. The substantial variability found confirms an inherent limitation of visual microscopic diagnosis.

Topics: cytology, thyroid nodule, malignant neoplasm of thyroid, histopathology tests, thyroid, bethesda system ...
  

This review informs the updated U.S. Preventive Services Task Force (USPSTF) recommendation on screening for peripheral artery disease (PAD) and cardiovascular disease (CVD) risk assessment with the ankle–brachial index (ABI) in adults. It found limited evidence on the added value of the ABI in current coronary artery disease or CVD risk prediction, as well as limited trial evidence for treatment of CVD in persons with asymptomatic or minimally symptomatic PAD.

Topics: peripheral vascular diseases, cardiovascular diseases, cardiovascular disease risk factors, ankle brachial ratio ...
  

The USPSTF concluded that the current evidence is insufficient to assess the balance of benefits and harms of PAD screening and does not recommend for or against screening with the ABI. This recommendation applies to asymptomatic adults who do not have a known diagnosis of PAD, CVD, severe chronic kidney disease, or diabetes.

Topics: peripheral vascular diseases, cardiovascular diseases, cardiovascular disease risk factors, ankle brachial ratio ...
  

The USPSTF now recommends screening for hepatitis C virus (HCV) infection in all asymptomatic persons at high risk for infection and recommends offering 1-time screening for adults born between 1945 and 1965. This recommendation applies to all asymptomatic adults without known liver disease or functional abnormalities.

Topics: hepatitis c, hepatitis c virus
  

Agreeing with a U.S. senator that an Organ Procurement and Transplantation Network policy discriminates against children, a District Court judge in Philadelphia issued a 10-day restraining order, which enabled a 10-year-old child to receive a lung transplant from an adult. This commentary discusses the implications of this decision and provides suggestions on changes that would improve the supply and allocation of transplantable organs.

Topics: lung transplantation, lung, organ transplantation, resource allocation, transplantation
  

The recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is regarded as the primary source of information for psychiatric diagnostic criteria, but criticisms have arisen. In this commentary, a practicing internist-psychiatrist highlights important improvements in the DSM-5 that he believes make it more user-friendly for primary care providers.

Topics: diagnosis, diagnostic and statistical manual, mental disorders, psychiatry
  

This issue includes the updated USPSTF recommendation on ABI screening for PAD and CVD risk assessment, as well as the systematic review used to inform it. The USPSTF concluded that the current evidence is insufficient and recommended neither for nor against screening with the ABI. The editorialist discusses the recommendation and review and calls for a definitive randomized, controlled trial to determine whether ABI screening improves health outcomes in persons at risk for PAD.

Topics: peripheral vascular diseases, cardiovascular diseases, cardiovascular disease risk factors, ankle brachial ratio, ...
  
Quyen Ngo-Metzger, MD, MPH; John W. Ward, MD; and Ronald O. Valdiserri, MD, MPH

This issue includes the USPSTF recommendation on screening for HCV infection, which recommends screening all asymptomatic persons at high risk and offering 1-time screening for adults born between 1945 and 1965. The editorialists discuss the recommendation and conclude that it is a critical step forward in increasing the number of persons living with HCV who are aware of their infection status so that they may seek treatment and avoid infecting others.

Topics: hepatitis c, hepatitis c virus
  

As a community pharmacist, I cannot be expected to be a patient's primary care provider. However, it seems that improving the patient-centeredness rather than the profit-centeredness of pharmacy care would prevent lost opportunities for patient–provider dialogue.

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Timothy J. Daskivich, MD; Mark S. Litwin, MD, MPH; and David F. Penson, MD, MPH
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Thierry Poynard, MD, PhD; Vlad Ratziu, MD, PhD; and Mona Munteanu, MD
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Paul Calès, MD; Victor de Ledinghen, MD; and Jérôme Guéchot, PharmD, PhD
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Rosemary D. Lombard
Includes: Audio/Video
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Julia Kreger, BA
Includes: Audio/Video
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Adam Gilden Tsai, MD, MSCE; and Thomas A. Wadden, PhD
Includes: CME
Topics: obesity, bariatric surgery, weight-loss agents, overweight, overweight and obesity prevention
  
Topics: adrenal corticosteroids, carpal tunnel syndrome, methylprednisolone, steroids, corticosteroid injections, local
  
Topics: peripheral vascular diseases, cardiovascular diseases, cardiovascular disease risk factors, ankle brachial ratio ...
  
Topics: hepatitis c, hepatitis c virus
  
Topics: hepatitis c, advisory committees, united states preventive services task force, prevention
  
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