Annals for Educators - 19 March 2019

Annals for Educators - 5 March 2019

Management of Menopausal Symptoms

Annals for Educators - September 2026

Delirium

Delirium is a common, acute confusional state that is associated with adverse patient, caregiver, and health system outcomes. All patients are at risk for delirium, although those with advanced age or acute infection and those taking sedatives and anticholinergics are at greater risk. The pathophysiology of delirium is complex and includes neuronal injury, inflammation, metabolic imbalance, and blood–brain barrier disruption. It is important to note that delirium is preventable; recognizing people at risk and identifying and addressing predisposing and precipitating factors is paramount. No single intervention or medication has been shown to be effective in treating delirium; therefore, standard-of-care treatments rely on multifaceted strategies to address contributing factors.

The New ACP Clinical Guideline for the Pharmacologic Treatment of Menopausal Vasomotor Symptoms: Where Do We Go From Here?

Functional seizures tough to recognize

How Would You Screen This 26-Year-Old Woman for Cervical Cancer? Grand Rounds Discussion From Beth Israel Deaconess Medical Center

Cervical cancer is the third most common gynecologic cancer, with more than 13 000 new cases diagnosed in 2025. The incidence of and mortality from cervical cancer vary across racial and ethnic groups and in persons living in medically underserved or geographically isolated areas, with half of all cervical cancers occurring in women who are underscreened or have never been screened. Persistent infection with high-risk types of human papillomavirus (HPV) is the most important risk factor for cervical cancer and is associated with nearly all cases. Although genital tract HPV infection is common, most HPV infections are transient, and cervical cancer occurs in only a small portion of patients with HPV. For decades, cervical cancer screening relied on annual cytologic assessment. A growing understanding of the role of HPV infection in the natural progression of cervical cancer has led to updated screening recommendations from the American Cancer Society and the Women’s Preventive Services Initiative, as well as a draft update from the U.S. Preventive Services Task Force. These recommendations include primary HPV testing as a preferred screening strategy and include an option for self-collected specimens for HPV testing. Here, 2 experts in this field, a primary care physician and an obstetrics and gynecology physician, debate how to apply these guidelines when screening a patient for cervical cancer. They discuss a range of screening options and consider the challenges of applying these guidelines across different age groups and in patients at increased risk.

Effectiveness and Safety of Treatments to Prevent Fractures in People With Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians (Version 1: Update Alert 2)

Inflammatory Bowel Disease

The global burden of inflammatory bowel diseases (IBD) continues to rise, placing increasing demands on primary care and specialty practices alike. Beyond disease control, patients with IBD face heightened risks related to chronic inflammation and long-term immunosuppressive therapy, including infection, cancer, bone loss, nutritional deficiencies, and mental health disorders. Proactive, structured health care maintenance encompassing vaccination, cancer screening, bone and cardiometabolic health, nutrition, and psychosocial well-being is essential to optimize long-term outcomes. Effective delivery of this care depends on close collaboration and clearly defined shared responsibilities between gastroenterologists and primary care physicians. This review outlines evidence-based strategies for health care maintenance in the outpatient management of adults with IBD.