Researchers found COVID-19 positive results in sputum and feces samples of patients with negative pharyngeal swabs, suggesting additional body site sampling may be needed. The study highlights the need for further investigation into patient safety and infectiousness after discharge.
The COVID-19 pandemic has significantly impacted cancer care delivery, leading to concerns about treatment delays and reduced access to care. To address these challenges, experts recommend adopting flexible approaches that prioritize patient needs and minimize disruptions.
Screening for thyroid-stimulating hormone receptor antibodies (TSH-R-Abs) before pregnancy is crucial for patients with a history of autoimmune thyroid disease. This is because TSH-R-Abs can lead to irreversible impairment in fetal neurodevelopment. A case report highlights the importance of screening, especially in women with Graves' ...
The article provides guidance on supporting clinicians during the COVID-19 pandemic. Key findings highlight the importance of maintaining a patient-centered approach and adapting to new clinical challenges.
A cross-sectional survey in the US and UK found that the general public has varying levels of knowledge about COVID-19, with some misunderstanding key concepts. The study suggests that targeted education efforts could improve public understanding and adherence to prevention measures.
A systematic review and meta-analysis found that dual therapy with a direct oral anticoagulant (DOAC) plus P2Y12 inhibitor was associated with reduced risk of major bleeding compared to triple therapy with a vitamin K antagonist (VKA) plus aspirin and P2Y12 inhibitor for patients with nonvalvular atrial fibrillation after percutaneous ...
Researchers analyzed lung tissue from a COVID-19 patient to investigate histopathologic changes and SARS-CoV-2 immunostaining. The study found distinct patterns of immune cell activation and inflammation, shedding light on the disease's pathophysiology.
Two new articles published in Annals of Internal Medicine provide guidance on how US hospitals can prepare for the ongoing COVID-19 pandemic. The first article offers ideas for protecting hospitals from the invisible threat of coronavirus, while the second article provides recommendations for preparing hospitals for a surge in cases.
A new branded HIV pre-exposure prophylaxis (PrEP) drug, emtricitabine/tenofovir alafenamide (F/TAF), has been approved but found not to be cost-effective compared to generic formulation F/TDF. The study suggests that the high cost of F/TAF may undermine efforts to expand access to PrEP for the most vulnerable populations.
A large cohort study published in Annals of Internal Medicine found that apixaban was associated with a lower risk of stroke or systemic blood clots compared to rivaroxaban in patients with nonvalvular atrial fibrillation. The study also showed that apixaban was linked to a lower risk of gastrointestinal bleeding or bleeding in the brain.
Researchers estimate the median incubation period of COVID-19 to be 5.1 days, with 97.5% of cases developing symptoms within 11.5 days of infection. This supports current CDC recommendations for active monitoring and quarantine.
A novel cause of fatty liver disease has been discovered in lean individuals undergoing immune checkpoint blockade therapy. Researchers report a case of a woman who experienced severe inflammation of her subcutaneous fat and developed nonalcoholic fatty liver disease after treatment with the PD-1 inhibitor Nivolumab.
Adding travel history to patient evaluation could help identify risk for potential exposure to COVID-19. The authors argue that this simple measure can trigger more detailed history, appropriate testing, and rapid implementation of protective measures.
Researchers found a small mortality benefit for continuing mammography screening in women between 70-74 years old, but no benefit for those over 75. Women who continued screening were less likely to receive aggressive therapies for breast cancer.
A study found that low-dose methotrexate was associated with a small increase in adverse events, such as skin cancer and gastrointestinal problems. However, the risk for kidney-related side effects was decreased. The findings suggest that monitoring guidelines and safe prescribing of LD-MTX may need to be revised.
A novel vaccine called Triplex reduced CMV complications by half and induced immunity in patients undergoing allogeneic hematopoietic stem cell transplant. No vaccine-associated safety concerns were identified in the phase 2 randomized clinical trial.
The ACIP released its 2020 Recommended Immunization Schedule for adults with changes to vaccine administration and shared clinical decision-making. The schedule includes new instructions for discussing HPV vaccination, pneumococcal conjugate vaccines, and meningitis B vaccines.
A microsimulation study found that nurse home visits improved health outcomes and reduced readmissions for patients with heart failure, while also being more effective than standard care. The intervention increased quality-adjusted life years (QALYs) and costs, resulting in an ICER of $19,570 per QALY gained.
The American College of Physicians (ACP) releases a new vision for a better US healthcare system, emphasizing universal coverage, reduced barriers to care, and value-based payment systems. The plan aims to improve health outcomes, reduce costs, and promote patient-centered care.
The American College of Physicians releases a series of policy papers recommending systemic reforms to achieve better healthcare for all. The recommendations address coverage and cost of care, healthcare payment and delivery systems, barriers to care, and social determinants of health.
A recent study published in Annals of Internal Medicine found that adults with type 2 diabetes who were newly prescribed SGLT2 inhibitors had a lower rate of gout compared to those prescribed GLP1 agonists. This suggests that SGLT2 inhibitors may be effective in reducing the risk of gout among patients with type 2 diabetes.
The American College of Physicians recommends treating testosterone deficiency for only sexual dysfunction, discontinuing treatment if symptoms don't improve, and avoiding other reasons for treatment. Testosterone treatment should not be initiated to boost energy or cognitive function due to lack of evidence.
The American College of Physicians recommends testosterone treatment for men with age-related low testosterone only to treat sexual dysfunction. Testosterone treatment has shown small improvements in sexual and erectile function, but not in energy, vitality, or cognition.
A randomized study found that MIV-711 significantly reduced bone and cartilage progression in knee osteoarthritis patients. However, the treatment had no beneficial effects on osteoarthritic knee pain.
A cohort study found that preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations were independently associated with vascular death or myocardial injury at 30 days after surgery. Preoperative NT-proBNP thresholds improved discrimination and risk stratification for patients undergoing noncardiac surgery.
A randomized controlled trial found that substitutive home hospital care reduced costs, decreased health care use, and 30-day readmissions compared to traditional hospital care. The study also showed improved physical activity among patients receiving home hospital care. This model could transform how acute care is delivered in the US.
A new study published in Annals of Internal Medicine found that extending the HPV vaccination age to include women and men up to 45 would produce small, but significant health benefits. The study used a health economic model to evaluate the added effectiveness and cost-effectiveness of such an extension.
A nationwide population-based study found that firearms are the most lethal method for suicide, with nearly 9 out of 10 attempts being fatal. The overall fatality rate for suicide attempts nationwide is 1 out of 12. The study suggests that prevention efforts focused on reducing access to firearms could save lives.
Researchers found that recovering from metabolic syndrome significantly reduced the risk of cardiovascular disease in a nationwide population-based cohort study. In contrast, developing or remaining in metabolic syndrome was associated with an increased risk of cardiovascular disease.
A systematic review and meta-analysis found that bedside optic nerve ultrasound is an accurate diagnostic tool for detecting increased intracranial pressure, particularly in children and adults. The test involves a non-invasive ultrasound of the eye to reflect pressure inside the brain.
The American College of Physicians recommends improving transparency, lowering out-of-pocket costs for patients, and enhancing access to affordable medications. The policies aim to stem the escalating costs of prescription drugs by increasing oversight and regulation of Pharmacy Benefit Managers and public health plans.
The American College of Physicians (ACP) has issued policy recommendations aimed at mitigating the rising costs of prescription drugs, including increasing transparency and lowering out-of-pocket costs for patients. The recommendations also focus on improving access to affordable medications and addressing issues in public health plans.
The American College of Physicians recommends screening for colorectal cancer in adults at average risk who do not have symptoms. The recommended screening frequency varies depending on the chosen strategy, with options including fecal immunochemical tests, colonoscopy, and flexible sigmoidoscopy.
The American College of Physicians (ACP) has released a new guidance statement for colorectal cancer screening in average-risk adults between 50 and 75 years old. The guidance suggests that physicians select the most suitable screening test for each patient based on factors such as benefits, harms, costs, availability, frequency, and p...
China's obesity rates have nearly tripled over the past decade, reaching 14% for general obesity and 32.4% for abdominal obesity among adults. A cluster of high obesity prevalence was identified in the Beijing-Tianjin-Hebei region, highlighting the need for targeted interventions to address this growing health concern.
Screening for ever-smokers with high lung cancer risk and long life-expectancy can prevent more deaths than current guidelines. A new study suggests using gains in life expectancy as a criterion to select candidates for screening, which could improve the balance of benefits and harms.
A systematic review and meta-analysis found that nonpharmacologic treatments, such as massage and touch therapy, were more effective than pharmacologic treatments in reducing aggression and agitation in adults with dementia. The authors recommend prioritizing nonpharmacologic approaches over medications due to potential harms associate...
A systematic review suggests that published studies on burnout and patient care quality may exaggerate the magnitude of the effect. The review analyzed 145 study populations and found that many results were due to biases in measurement and analysis, leading to overestimation of the relationship between burnout and poor quality care.
A panel of experts based on rigorous systematic reviews found little to no health benefits for reducing red or processed meat consumption. Most adults can continue their current levels of red and processed meat intake without negative health effects.
A study of 1,461 hospital data breaches found that 71% compromised sensitive demographic or financial information, putting patients at risk of identity theft. The breaches also revealed a lack of transparency about the types of information compromised, sparking calls for policymakers to require standardized documentation.
Researchers found that 2.5% of women and 12.1% of men without established CVD could derive net benefit from aspirin treatment for 5 years. The study used data from a well-characterized web-based decision support program in New Zealand, identifying persons likely to benefit from aspirin treatment based on personalized benefit-harm analy...
Women who started estrogen therapy before age 60 with their ovaries removed experienced reduced mortality over long-term follow-up. However, older women or those above 70 without ovaries did not derive this benefit and may have adverse effects of treatment.
A poor diet caused permanent vision loss in a 14-year-old patient, according to a case report published in Annals of Internal Medicine. Vitamin B12 deficiency and inadequate nutrient intake led to nutritional optic neuropathy, a rare condition that can cause irreversible blindness if left untreated.
A systematic review found moderate-strength evidence supporting face-to-face CBT in reducing suicidal ideation, as well as low-strength evidence suggesting DBT's effectiveness. Pharmaceutical treatments like ketamine and lithium showed promise in reducing suicidal ideation and suicide rates, respectively.
A nationwide cohort study found that lipophilic statin use was associated with significantly lower risk of hepatocellular carcinoma (HCC) incident, all-cause death, and liver-related death. The benefits were dose and duration-dependent, with the greatest reduction in HCC risk occurring after at least 600 cumulative defined daily doses.
The American College of Physicians (ACP) has developed a rigorous process for disclosing interests and managing conflicts of interest to ensure transparency, proportionality, and consistency in clinical guideline development. The process applies to all individuals involved in ACP's clinical guidelines and guidance statements.
A new study examines the effectiveness of extreme risk protection orders (ERPOs), also known as 'red flag' laws, in preventing mass shootings. The research analyzed 21 cases and found that ERPOs had prevented all threatened shootings, with no other homicides or suicides by persons subject to the orders.
Research published in Annals of Internal Medicine found that both general and abdominal obesity were strongly associated with mortality among Mexican adults. The study, which followed over 115,000 adults for up to 14 years, also found that waist-to-hip ratio was a major risk factor for premature death.
The American College of Physicians, along with leading physician and public health organizations, calls for policies to reduce firearms-related injuries and deaths. Comprehensive criminal background checks, research into the causes of firearm violence, and improved access to mental health care are recommended.
Research from the University of Sydney found that electric fans lowered core temperature and cardiovascular strain in hot, humid conditions, but were detrimental in very hot, dry conditions. The study highlights the limitations of using heat index values to recommend fan use during heat waves.