U.S.

Millions of Americans affected by Long COVID (LC) report difficulty accessing care and support. One barrier is obtaining a diagnosis. In response, US federal agencies commissioned a National Academies of Sciences, Engineering, and Medicine (NASEM) committee to re-examine the existing federal definitions for LC. The Committee concluded that LC is "an infection-associated chronic condition (IACC) occurring after SARS-CoV-2 infection that is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that can present as singular or multiple symptoms and/or diagnosable conditions." The full report was released in June 2024. We briefly highlight features and aspects of the definition that may help clinicians identify those who remain undiagnosed and improve care for all LC patients.

Author/s:

Lily Chu, Karyn Bishof, Abigail A Dumes, E Wesley Ely, Paule V Joseph, Andrea B Troxel

The Management of Major Depressive Disorder: Synopsis of the 2022 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline

Aubrey Delammermore — Sat, 24 Sep 2022 05:00:00 +0000

Date Added:

September 24, 2022

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

September 20, 2022

Issue:

Volume:

URL:

The Management of Major Depressive Disorder: Synopsis of the 2022 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M22-1603

Keywords

Department of Veterans Affairs

veterans

Department of Defense

Algorithms

alternative therapies

PMID (1):

36122380

MeSH

Complementary Therapies

Depressive Disorder

Major

Telemedicine

National Academies of Science

Engineering

and Medicine

U.S.

Health and Medicine Division

pharmacogenetics

An updated guideline on treatment of patients with major depressive disorder from the VA and DoD. James W. Mold, MD, MPH

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Abstract
Description: In February 2022, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved a joint clinical practice guideline (CPG) for the management of major depressive disorder (MDD). This synopsis summarizes key recommendations.

Methods: Senior leaders within the VA and the DoD assembled a team to update the 2016 CPG for the management of MDD that included clinical stakeholders and conformed to the National Academy of Medicine's tenets for trustworthy CPGs. The guideline panel developed key questions, systematically searched and evaluated the literature, created two 1-page algorithms, and distilled 36 recommendations for care using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Select recommendations that were identified by the authors to represent key changes from the prior CPG are presented in this synopsis.

Recommendations: The scope of the CPG is diverse; however, this synopsis focuses on key recommendations that the authors identified as important new evidence and changes to prior recommendations on pharmacologic management, pharmacogenomics, psychotherapy, complementary and alternative therapies, and the use of telemedicine.

Author/s:

McQuaid, J. R., Buelt, A., Capaldi, V., Fuller, M., Issa, F., Lang, A. E., Hoge, C., Sall, J., Wiechers, I. R., Williams, S.

Interim Guidance for Rapid Antigen Testing for SARS-CoV-2

Brian Desmarais — Thu, 20 Aug 2020 14:26:20 +0000

Date Added:

August 20, 2020

Publisher:

Centers for Disease Control and Prevention

Publication Date:

August 16, 2020

URL:

Interim Guidance for Rapid Antigen Testing for SARS-CoV-2

Type:

Public Health Announcements

Format:

Web Page

MeSH

Coronavirus

COVID-19

point-of-care systems

severe acute respiratory syndrome coronavirus 2

Coronavirus Infections

pandemics

Point-Of-Care Testing

Centers for Disease Control and Prevention

U.S.

Interim guidance from the CDC on the use of rapid antigen tests for COVID-19. James W. Mold, MD, MPH

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Not available.

Multisystem Inflammatory Syndrome in U.S. Children and Adolescents

Brian Desmarais — Fri, 03 Jul 2020 19:52:28 +0000

Date Added:

July 3, 2020

Journal/Publication:

New England Journal of Medicine

Publication Date:

June 29, 2020

URL:

Multisystem Inflammatory Syndrome in U.S. Children and Adolescents

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1056/NEJMoa2021680.

MeSH

Centers for Disease Control and Prevention

U.S.

severe acute respiratory syndrome coronavirus 2

A summary of the clinical characteristics and clinical course of 186 children with multi-inflammatory syndrome (MIS-C). James W. Mold, MD, MPH

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Abstract

BACKGROUND

Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome.

METHODS

We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms.

RESULTS

We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores ≥2.5) were documented in 15 patients (8%), and Kawasaki’s disease–like features were documented in 74 (40%). Most patients (171 [92%]) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%).

CONCLUSIONS

Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents. (Funded by the Centers for Disease Control and Prevention.)

Author/s:

Feldstein, L.R., et al.

Preparing Nursing Homes and Assisted Living Facilities for Covid-19

Brian Desmarais — Mon, 18 May 2020 15:47:47 +0000

Date Added:

May 18, 2020

Publisher:

Centers for Disease Control and Prevention

Publication Date:

May 1, 2020

URL:

Preparing Nursing Homes and Assisted Living Facilities for Covid-19

Type:

Public Health Announcements

Format:

Video

MeSH

severe acute respiratory syndrome coronavirus 2

COVID-19

nursing homes

Communications Media

Centers for Disease Control and Prevention

U.S.

fungi

This 30-minute video from the CDC reviews precautions nursing homes and assisted living centers should take to prevent spread of COVID-19. James W. Mold, MD, MPH

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Not available.

Author/s:

Long-term Care Team, Prevention and Response Brach Division of Healthcare Quality Promotion

Coding for Coronavirus: NEW Guidance Replaces the Rule of 1 Month Ago

Brian Desmarais — Thu, 02 Apr 2020 02:51:06 +0000

Date Added:

April 1, 2020

Journal/Publication:

Medscape Family Medicine

Publication Date:

March 30, 2020

URL:

Coding for Coronavirus: NEW Guidance Replaces the Rule of 1 Month Ago

Type:

Practice Management Reviews and Guidelines

Format:

Web Page

Keywords

MeSH

International Classification of Diseases

health personnel

physicians

Centers for Disease Control and Prevention

U.S.

A new ICD-10 code, U07.1, has been created for confirmed cases of COVID19. Additional codes can be added for complications like pneumonia. James W. Mold, MD, MPH

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Not available.

Author/s:

Nicoletti, B.

Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017

John Bayhi — Sat, 14 Mar 2020 20:31:53 +0000

Date Added:

March 14, 2020

Journal/Publication:

MMWR Morbidity and Mortality Weekly Report

Publisher:

Centers for Disease Control and Prevention

Publication Date:

March 13, 2020

Issue:

Volume:

Pages:

265-270

URL:

Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.15585/mmwr.mm6910a3

Keywords

alcohol use

screening and brief intervention

alcohol SBI

binge drinking

PMID (1):

32163383

MeSH

Behavioral Risk Factor Surveillance System

Fetal Alcohol Spectrum Disorders

Public Health Practice

health personnel

Evidence-Based Medicine

insurance coverage

Telephone

Centers for Disease Control and Prevention

U.S.

Longitudinal Studies

The CDC recommends screening all adults for binge drinking with a single question and recommending reduction to those who screen positive. James W. Mold, MD, MPH

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What is already known about this topic?

Binge drinking increases the risk for adverse health conditions and death. Alcohol screening and brief intervention (SBI), recommended by the U.S. Preventive Services Task Force (USPSTF) for all adults in primary care, is effective in reducing binge drinking.

What is added by this report?

In 2017, 81% of survey respondents were asked by their health care provider about alcohol consumption and 38% about binge drinking at a checkup in the past 2 years. Among those asked about alcohol use and who reported current binge drinking, 80% received no advice to reduce their drinking.

What are the implications for public health practice?

Implementation of alcohol SBI as recommended by USPSTF, coupled with population-level evidence-based interventions, can reduce binge drinking among U.S. adults.

Author/s:

McKnight-Eily, LR, Okoro, CA, Turay, K, Acero, C, Hungerford, D

Summary of Revisions: Standards of Medical Care in Diabetes—2020

John Bayhi — Sat, 14 Mar 2020 19:35:38 +0000

Date Added:

March 14, 2020

Journal/Publication:

Diabetes Care

Publisher:

American Diabetes Association

Publication Date:

January 1, 2020

Issue:

Supplement 1

Volume:

Pages:

S4-S6

URL:

Summary of Revisions: Standards of Medical Care in Diabetes—2020

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.2337/dc20-Srev

Keywords

PMID (1):

31862743

MeSH

Sodium-Glucose Transporter 2 Inhibitors

Diabetic Ketoacidosis

Ficus

Glucagon-Like Peptide-1 Receptor

glycated hemoglobin a

cardiovascular diseases

Consensus

Farmers

Cystic Fibrosis

Transients and Migrants

Pharmaceutical Preparations

depression

Smell

Patient Comfort

electronic nicotine delivery systems

Blood Glucose Self-Monitoring

celiac disease

follow-up studies

Latent Autoimmune Diabetes in Adults

seasons

social determinants of health

Standard of Care

Time-to-Treatment

united states food and drug administration

risk reduction behavior

Centers for Disease Control and Prevention

glucagon-like peptide 1

anxiety disorders

Feeding and Eating Disorders

thyroid diseases

Infections

This is a three-page summary of the 2020 updates to the ADA Guidelines for Type 2 diabetes. James W. Mold, MD, MPH

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No abstract available.

Vaccination of Adults in General Medical Practice

Brian Desmarais — Fri, 03 Jan 2020 19:37:26 +0000

Date Added:

January 3, 2020

Journal/Publication:

Mayo Clinic Proceedings

Publication Date:

January 1, 2020

Issue:

Volume:

Pages:

169–183

URL:

Vaccination of Adults in General Medical Practice

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1016/j.mayocp.2019.02.024

Keywords

adult immunization

A review of adult immunization recommendations from Mayo. James W. Mold, MD, MPH

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In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.

Author/s:

Hunter, P., Fryhofer, S.A., Szilagyi, P.