Articles related to GUIDELINES/RECOMMENDATIONS

In a look “Beyond the Guidelines,” a preventive cardiologist and a general internist discuss their approach in the case of a 57-year-old woman with high cholesterol and a family history of heart disease.

Harvard assistant professor of psychiatry comments on a new trend to treat BPD by generalists using brief steps of care. This approach enables clinicians who are not specialists to diagnose the disorder and guide the patient in navigating care one step at a time — in any clinical setting.

Per guidelines, cancers with HER2 expression with a score of 3+ was considered HER2-positive. Cancers with scores of 0 and 1+, or those with an IHC score of 2+ and a negative ISH result, have been characterized as HER2-negative. These guideline-directed binary distinctions — HER2-positive vs HER2-negative — have until now guided physicians’ treatment decisions. New research suggests that patients with HER2-2+, ISH-negative breast cancer present a clinical picture closer to that of patients with HER2-positive breast cancer.

The CDC continue to recommend Paxlovid for early-stage treatment of mild-to-moderate COVID-19 among individuals at high risk of progression to severe disease. Recent case reports suggest that some patients treated with Paxlovid may have a recurrence of COVID-19 symptoms two to eight days after completing the five-day course of treatment. Both the illness and the positive test results resolved, on average, three days later without the need for additional treatment.

The Infectious Diseases Society of America (IDSA) has issued guidance on managing drug interactions with nirmatrelvir/ritonavir (Paxlovid). Specifically, the IDSA recommends clinicians take six steps to minimize the risk of drug interactions for patients with COVID-19 who are eligible for nirmatrelvir/ritonavir.

There haven’t been any national guidelines developed for managing patients with stage 1 hypertension who don’t respond to lifestyle modification. This population represents an important guideline gap: most patients with stage 1 hypertension progress to stage 2 hypertension, which increases the risk for cardiovascular events. The AHA has published a scientific statement to fill the gap – if lifestyle modification fails to reduce blood pressure, consider pharmacotherapy.