The American journal of medicine
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This CME-accredited CME Snapshot™ four-part series is intended for primary care providers, including internists, family physicians, nurse practitioners, and physician assistants involved in the ongoing management of patients with severe asthma. The faculty will review freely available patient- and caregiver-directed educational resources that seek to improve shared decision-making and multidisciplinary care.). (Online access: https://asthmacmepcp.elsevierresource.com/).
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COVID-19 is associated with increased risk of post-acute cardiovascular outcomes. Population-based evidence for long periods of observation is still limited. ⋯ SARS-CoV-2 infection was associated with higher cardiovascular risk, with graded increase across the acute COVID-19 severity, contributing to 7% of incident major adverse cardiovascular events. These findings suggest that long-term monitoring of cardiovascular risk is required in COVID-19 survivors.
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Review
Injecting New Ideas Into Managing Type 2 Diabetes: Evolving Roles of GLP-1 Receptor Agonists.
Type 2 diabetes is a progressive disease that often requires therapeutic intensification. Patients with type 2 diabetes frequently experience complications related to hyperglycemia, treatment-induced hypoglycemia, and comorbidities. Management of patients with type 2 diabetes is complicated and must be individualized, though guidelines from both the American Diabetes Association and the American Association of Clinical Endocrinologists/American College of Endocrinology provide treatment algorithms detailing therapeutic escalation with both oral and injectable therapies according to glycated hemoglobin (A1c) level. ⋯ These incretin-based therapies, available in both daily and weekly formulations, have been shown to significantly reduce A1c levels, body weight, and cardiovascular risk factors. In this 4-part series, 2 expert physicians discuss clinical profiles of GLP-1 receptor agonists, strategies to reduce cardiovascular risk in type 2 diabetes, barriers to the use of injectable noninsulin therapies, and practical recommendations for noninsulin injectable therapies. These accredited educational programs are available online at https://glp1cme.elsevierresource.com/.
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Many patients diagnosed with COVID-19 have persistent cardiovascular symptoms, but whether this represents a true cardiac process is unclear. This study assessed whether symptoms associated with long COVID among patients referred for cardiovascular evaluation are associated with objective abnormalities on cardiac testing to explain their clinical presentation. ⋯ This pragmatic retrospective cohort study suggests that patients with long COVID referred for cardiovascular evaluation infrequently have new, objective cardiovascular disease to explain their clinical presentation. A multidisciplinary, patient-centered approach is warranted for symptom management along with conservative use of diagnostic testing.