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.
Candida auris is a highly contagious, deadly fungus that causes severe infections; its emergence has highlighted gaps in fungal identification capacity worldwide. Early detection is crucial to controlling the spread of this drug-resistant fungus, which can be transmitted between patients in healthcare settings.
Nonprescription antibiotic use is a significant public health concern, with varying prevalence rates across different socioeconomic groups. The study highlights the need for increased awareness and education to prevent unnecessary antibiotic use and its associated adverse events.
Researchers found that cold snare polypectomy with continuous anticoagulant use does not increase bleeding risk, showing non-inferiority and even superiority over traditional methods. The study suggests that this procedure can be a safer alternative for patients taking blood thinners.
A new evidence review suggests that few nutritional supplements or dietary interventions offer any protection against cardiovascular disease or death. Some may even cause harm, according to a meta-analysis published in Annals of Internal Medicine.
A new guide from the American College of Physicians provides clinicians with a detailed framework for caring for transgender patients, highlighting specific medical issues and ways to improve practice. The guide also addresses broader concerns about healthcare access and disparities in marginalized populations.
Researchers found that Medicare Advantage beneficiaries had higher 30-day risk-adjusted readmission rates than traditional Medicare beneficiaries for three common medical conditions. Despite previous studies suggesting better post-acute care outcomes for Medicare Advantage enrollees, the study found no evidence of improved readmission ...
A retrospective cohort study found that patients who received opioids for the first time while hospitalized had double the risk of continuing to receive opioids for months after discharge. Researchers reviewed electronic health records of 191,249 hospital admissions and found that almost 6% of patients receiving opioids during their ho...
A study published in Annals of Internal Medicine found that women who were denied an abortion due to gestational age limit reported worse health 5 years later compared to those who underwent an abortion. The study also found similar physical health outcomes between women who had abortions in the first or second trimester and those who ...
The American College of Physicians has released a new paper outlining its methods for developing high-quality, evidence-based clinical policy papers. The methodology ensures that recommendations are based on the best available scientific evidence, considering clinical benefits, harms, costs, and patient values. ACP's approach includes ...
The American College of Physicians has released a position paper outlining professional duties and principles for responding to physician impairment. The guidelines emphasize the importance of rehabilitation and reintegrating impaired physicians into medical practice while ensuring patient safety.
A new essay published in Annals of Internal Medicine argues that physicians often have to make difficult decisions when faced with extreme political pressures. The author shares a personal story about caring for a pregnant woman who was forced to carry a baby without a brain, highlighting the need for compassion over 'choice' in patien...
A mathematical model found that physician burnout costs the US healthcare system approximately $4.6 billion per year, with potential economic value for reducing burnout through policy and organizational efforts. Accessing patient notes may also improve medication adherence and patient comfort.
Researchers found that glucocorticoid use, especially above 10mg/d, was associated with increased risk for infections, readmission, and prosthetic joint infections among RA patients undergoing joint replacement surgery. Biologics had similar risks across treatments.
The T2Bacteria Panel accurately diagnoses common bloodstream infections in 3-8 hours, compared to 24-72 hours for blood cultures. This rapid diagnosis may improve clinical outcomes by shortening the time to appropriate antibiotic treatment.
A rare but potentially fatal infection of the genitals has been identified as a side effect of SGLT2 inhibitors, requiring immediate attention and surgical intervention. Awareness of this association can inform prescriber-patient discussions about appropriate diabetes therapy.
A study found that poor sense of smell is associated with a 46% higher mortality rate at year 10 and 30% higher mortality rate at year 13 compared to those with good olfaction. The association could not be explained by demographic characteristics, lifestyle, or comorbid conditions.
A study published in Annals of Internal Medicine found that metformin helped patients maintain weight loss over a period of 15 years. The researchers identified being older and losing a greater amount of weight in the first year as key predictors of lasting weight loss.
A study published in Annals of Internal Medicine found that low scam awareness in older adults may be an early sign of impending mild cognitive impairment and dementia. The researchers observed a significant association between low scam awareness and Alzheimer disease pathology in the brain.
The American College of Physicians recommends strengthening the Affordable Care Act to address gaps in coverage and ensure universal access. ACP calls for bolstering the insurance market, expanding Medicaid, and increasing competition to provide quality care for all Americans.
The American College of Physicians recommends that average-risk women between 50 and 74 years old undergo breast cancer screening with mammography every other year, as this approach balances benefits and harms. This strategy reduces false-positive findings and overtreatment, while minimizing radiation exposure and related risks.
The American College of Physicians (ACP) has issued a new guidance statement on breast cancer screening for average-risk women, recommending mammography every other year beginning at age 50. The guidelines take into account the potential harms of overdiagnosis and overtreatment associated with annual or biennial screening.
In a phase 3 randomized, double-blind, placebo-controlled trial, researchers found that B-cell depletion using rituximab over 12 months was not associated with clinical improvement in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The study, published in Annals of Internal Medicine, contradicts previous phas...
After Colorado's marijuana legalization, a three-fold increase was seen in cannabis-related emergency department visits. Edible exposure led to about 33 times more ED visits than expected. Psychiatric ED visits were also more common following edible consumption.
A systematic evidence review found that behavioral therapy is generally more effective than pharmacologic therapies in improving outcomes for women with urinary incontinence. The review included 84 studies and showed that all interventions studied resulted in better UI outcomes than no treatment.
Complete surgical removal of the thyroid gland improved symptoms in patients with Hashimoto thyroiditis, including profound fatigue, poor sleep quality, and muscle tenderness. Thyroidectomy also normalized serum antithyroid peroxidase (anti-TPO) antibodies, providing a more effective treatment option for these patients.
A nationwide cohort study of Danish children found no link between MMR vaccination and autism. The study included 657,461 children and analyzed their risk for autism after vaccination. No increased risk was observed in susceptible subgroups or during specified time periods.
The Annual FIT home stool test is effective for colon cancer screening in asymptomatic adults, with moderate to high sensitivity and specificity. Adopting this non-invasive test could improve lagging CRC screening rates, especially among vulnerable populations.
A Chinese national screening project found that only 0.6% and 2.4% of individuals with high cardiovascular risk were using statins and aspirin, respectively. The study highlights the need for increased risk mitigation in China's population.
Research suggests that low physical fitness, obesity, and a combination of both are strongly associated with chronic disability later in life. The study found that being physically fit is an important indicator of health regardless of BMI, reducing the risk of disability.
Researchers found compounded pain creams ineffective in relieving localized pain, with small benefits attributed to peripheral nervous system drugs. The treatment's lack of efficacy and high cost make it less suitable than FDA-approved compounds.
A personalized decision aid failed to help surrogate decision makers and clinicians agree on treatment goals for critically ill patients. Nearly all surrogates chose a more aggressive treatment goal despite the aid being based on their patient's values.
A nationwide cohort study found that timely kidney transplant significantly increases survival in patients with lupus nephritis and end-stage renal disease. The study revealed a 70% reduction in overall risk of death, with benefits observed across various subgroups, including African Americans, Hispanics, Asians, and both sexes.
Researchers found that young-onset diabetes is associated with a higher risk of hospitalization for mental illness compared to usual-onset diabetes. The study also showed that adults with young-onset diabetes had excess hospitalizations across their lifespan.
The American College of Physicians has released a new edition of its Ethics Manual, providing guidance on complex issues in medicine. The updated manual covers topics such as precision medicine, genetic testing, telemedicine, and end-of-life care, offering practical advice for clinicians, educators, researchers, and policymakers.
Universal screening of individual blood donations for Zika virus is not cost-effective in the 50 US states during the first year. Screening was only cost-effective in high mosquito season in Puerto Rico, and finding suggests revisiting universal blood screening policy.
A study published in Annals of Internal Medicine found that canagliflozin, an SGLT2 inhibitor, is not associated with an increased risk of nonvertebral fractures among patients with type 2 diabetes. The research, which analyzed data from over 70 million patients, suggests that caution may still be necessary when prescribing canaglifloz...
A meta-analysis of randomized controlled trials found catheter ablation superior to conventional drug therapy for patients with atrial fibrillation and heart failure. The procedure was associated with reduced all-cause mortality, heart failure hospitalizations, and improved quality of life.
A daily dose of buprenorphine-naloxone is cost-effective compared to monthly injections of extended-release naltrexone, with similar effectiveness in quality of life and time abstaining from opioids. The researchers conclude that buprenorphine-naloxone should be preferred as the first-line treatment for opioid use disorder.
Breastfeeding did not mitigate increased cancer risk, and older women are more susceptible to enhanced risks. The study analyzed data from 15 prospective studies and found that the heightened risk continued for about 24 years after childbirth.
A modelling study suggests that statins may be significantly overprescribed for people with a 10-year cardiovascular disease risk between 7.5% and 10%. The study found that the benefits of statin therapy did not outweigh the harms until the 10-year CVD risk threshold was above 21% for men aged 70-75, highlighting the need to reassess g...
The American College of Physicians has released a set of principles to guide patient partnership in healthcare, aiming to improve health outcomes, practice efficiency, and patient satisfaction. The principles emphasize the importance of patients and families being active partners in their care, contributing to system development and ed...
Researchers found that a fractional dose of the 17D yellow fever virus vaccine provided protective levels of antibodies for over 10 years after vaccination. This finding supports the use of fractional doses in mass vaccination campaigns before outbreaks and eliminates the need for booster shots.
Physicians say firearms are within their lane, disagreeing with NRA's stance on gun violence prevention. The American College of Physicians is collaborating with the American Foundation for Firearm Injury Reduction in Medicine to provide funding for research and develop practice recommendations on firearm injury prevention.
A new computer tool has been developed to identify patients with chronic pulmonary embolism (PE) who can be safely treated at home. The tool uses a sensitive cardiac injury marker, troponin, to measure the severity of PE and predict patient outcomes.