Annals of internal medicine
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Gastroesophageal reflux disease (GERD) is a common medical condition presenting with heartburn, regurgitation, cough, hoarseness, and/or wheezing. Patients with classic GERD symptoms often do not require diagnostic studies before empirical treatment is initiated. However, if atypical features are present, including alarm symptoms for malignancy, or if symptoms do not respond to conventional treatment, upper endoscopy may be necessary. ⋯ In addition to histamine-2 receptor antagonist or proton-pump inhibitor therapy, which may be prescribed as needed or continuously, lifestyle and dietary modification are often advised. Here, 2 physicians, a primary care practitioner and a gastroenterologist, debate how to manage a patient with GERD symptoms. They discuss the diagnosis of this condition, its initial management, indications for upper endoscopy, and how to care for the patient whose condition does not respond to empirical therapy.
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Straub L, Bateman BT, Hernández-Díaz S, et al. Comparative safety of in utero exposure to buprenorphine combined with naloxone vs buprenorphine alone. JAMA. 2024;332:805-816. 39133511.
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Late career physicians (LCPs; physicians working beyond age 65 to 75 years) may be at higher risk for delivering unsafe care. To oversee LCPs, some health care organizations (HCOs) have adopted LCP policies requiring cognitive, physical, and practice performance screening assessments. Despite recent controversies, little is known about the content and implementation of such policies. ⋯ The Greenwall Foundation.
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Levy BT, Xu Y, Daly JM, et al. Comparative performance of common fecal immunochemical tests: a cross-sectional study. Ann Intern Med. 2024;177:1350-1360. 39222513.
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Anker SD, Friede T, von Bardeleben RS, et al; RESHAPE-HF2 Investigators. Transcatheter valve repair in heart failure with moderate to severe mitral regurgitation. N Engl J Med. 2024;391:1799-1809. 39216092.