Role of Clinician Specialty in Picking Up PrEP

HIV prevention remains a major public health challenge. In 2019, after years of new HIV diagnoses hovering around 38 000 individuals in the US per year, agencies across the US Department of Health and Human Services developed the Ending the HIV Epidemic in the US plan to reduce new HIV diagnoses by 90% by 2030. With setbacks from converging pandemics, in 2021 new infections hovered at 36 000. Thus, finding ways to optimize HIV prevention, including strategies such as pre-exposure prophylaxis (PrEP), is urgent.

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Ottobre 2024

Performance and Safety of the Extravascular Implantable Cardioverter-Defibrillator Through Long-Term Follow-Up: Final Results From the Pivotal Study

Circulation, Ahead of Print. Background: Substernal lead placement of the extravascular implantable cardioverter-defibrillator (EV ICD) permits both defibrillation at thresholds similar to those seen with transvenous ICDs and effective antitachycardia pacing (ATP), while avoiding the vasculature and associated complications. The global Pivotal study has shown the EV ICD system to be safe and effective through 6 months, but long-term experience has yet to be published. We aim to report the performance and safety of the EV ICD system throughout the study.Methods: The EV ICD Pivotal study was a prospective, global, single-arm, pre-market clinical study. Individuals with a class I or IIa indication for a single-chamber ICD per guidelines were enrolled. Freedom from major system- or procedure-related complications, as well as appropriate and inappropriate therapy rates, were assessed through 3 years using the Kaplan-Meier method. Anti-tachycardia pacing success was calculated using simple proportions.Results: An implant was attempted in 316 patients [25.3% female, 53.8±13.1 years old, 81.6% primary prevention, LVEF 38.9%±15.4%]. Of 299 patients with a successful implant, 24 experienced 82 spontaneous arrhythmic episodes that were appropriately treated with either ATP only (38, 46.3%), shock only (34, 41.5%), or both (10, 12.2%) for a Kaplan-Meier-estimated rate of first any appropriate therapy of 9.2% at 3 years. Antitachycardia pacing was successful in 77.1% (37/48) of episodes, and ATP usage significantly increased from discharge to last follow-up visit (P

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Settembre 2024

Interventions to Increase Follow-Up of Abnormal Stool-Based Colorectal Cancer Screening Tests in Safety Net Settings: A Systematic Review

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States. Despite evidence that screening effectively reduces incidence and mortality, screening is suboptimal, especially in safety net healthcare systems and federally qualified health centers (FQHCs). Safety net healthcare systems represent 25% of U.S. hospitals and are defined as hospitals that organize and deliver a significant level of healthcare and other related services to individuals without insurance, receiving Medicaid, and other vulnerable patients.

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Settembre 2024