75-year-old man • fatigue • unintentional weight loss • anemia • Dx?

► Fatigue ► Unintentional weight loss ► Anemia.

Librarian Contributions to a Regional Response in the COVID-19 Pandemic in Western North Carolina.

At the start of the COVID-19 pandemic, the Mountain Area Health Education Center formed a response team with the goal of building capacity across Western North Carolina health systems to collectively identify needs, coordinate resources to fill gaps, and strategically manage the regional threats of the pandemic. The library team collaborated on interprofessional projects by gathering information and using LibGuides to quickly and easily organize and share resources. The team met challenges, including moving to telecommuting, balancing a growing workload, and navigating a changing information landscape, and in doing so, strengthened relationships across the organization and the region.

Does XR injectable naltrexone prevent relapse as effectively as daily sublingual buprenorphine-naloxone?

YES. MONTHLY EXTENDED-RELEASE INJECTABLE NALTREXONE (XR-NTX) TREATS OPIOID USE DISORDER AS EFFECTIVELY AS DAILY SUBLINGUAL BUPRENORPHINE-NALOXONE (BUP-NX) WITHOUT CAUSING ANY INCREASE IN SERIOUS ADVERSE EVENTS OR FATAL OVERDOSES. (STRENGTH OF RECOMMENDATION: A, 2 GOOD-QUALITY RCTS).

Medical-Legal Partnership in Western North Carolina: Addressing Social Determinants of Health Through Team-Based Care.

Having an attorney on a health care team helps address patients' social determinants of health. Through a medical-legal partnership, Pisgah Legal Services provides an attorney embedded within the Mountain Area Health Education Center clinical practices. The attorney impacts the Triple Aim of reducing costs by improving health and the patient experience.

Primary Care Behavioral Health Integration: Promoting the Quadruple Aim.

Chronic medical and common behavioral health conditions have been shown to benefit from team-based care approaches that include integrated behavioral health providers. Team-based integrated care can promote the Quadruple Aim, encompassing health care outcomes, patient satisfaction, provider work/life experience, and the cost of care.

Clinical Inquiries: What are the benefits and risks of daily low-dose aspirin for primary prevention of CV events?

One nonfatal myocardial infarction (MI) will be avoided for every 126 to 138 adults who take daily aspirin for 10 years (strength of recommendation [SOR]: A, systematic reviews and meta-analyses of multiple randomized controlled trials [RCTs]). Taking low-dose aspirin for primary prevention shows no clear mortality benefit. A benefit for primary prevention of stroke is less certain.

Clinical inquiry: what is the best beta-blocker for systolic heart failure?

Three beta-blockers--carvedilol, metoprolol succinate, and bisoprolol--reduce mortality equally (by about 30% over one year) in patients with Class III or IV systolic heart failure. Insufficient evidence exists comparing equipotent doses of these medications head-to-head to recommend any one over the others.

Clinical Inquiry: Can calcium supplements cause serious adverse effects in healthy people?

Yes, according to studies with some limitations. Calcium supplements with or without vitamin D increase the risk of myocardial infarction, with numbers needed to harm (NNH) over 5 years of 69 to 240 (strength of recommendation: B, meta-analyses of randomized controlled trials that evaluated a predominantly older female population and were limited by study designs).