Current guidelines on anticoagulation therapy for atrial fibrillation may be insufficient due to varying stroke rates among studies, suggesting a need for individualized risk assessments. A case report also highlights the successful treatment of multiple cancers with pembrolizumab in a patient with Lynch syndrome
Prescription drug shortages lead to estimated $230 million in annual costs due to rising prices and substitution drugs. Researchers found price increases reflect manufacturers' opportunistic behavior during shortages.
Researchers found that nearly 9% of people who died by suicide in 18 states between 2003 and 2014 had chronic pain documented in their incident records. Chronic pain was associated with risk factors for suicide, but previous studies primarily examined nonfatal suicidal behaviors.
Researchers found that nalbuphine effectively treated opioid-induced urine retention in a patient, suggesting it as a potential solution for those unable to use catheters. WHO guidelines also recently made recommendations on treatment intensification for type 2 diabetes and insulin use for type 1 and type 2 diabetes.
A recent survey found that about 4.5% of US adults use e-cigarettes, with higher rates among young adults and those in the LGBTQ community. E-cigarette use also varies by state, with estimates ranging from 3.1% in South Dakota to 7% in Oklahoma.
Viral suppression rates have nearly tripled in the US over the past two decades due to improved treatment regimens. However, disparities persist among younger persons and blacks living with HIV, warranting further research. The study found that these populations were more likely to have detectable viral loads.
The Women's Preventive Services Initiative recommends annual screening for urinary incontinence in all women, assessing symptom presence and impact on activities. Early intervention may reduce symptom progression and limit costly treatment needs.
Researchers found that transplantation followed by antiviral therapy cured hepatitis C in all 20 patients who received kidneys from infected donors. The treatment resulted in excellent renal function and stable to improved quality of life.
At least 1% of the US population has an identifiable genetic risk for cancer or heart disease that can be detected through genomic screening. Implementing routine genomic screening could lead to significant benefits, but more work is needed to develop functioning models.
A nationally representative survey suggests that Americans' view of marijuana use is more favorable than existing evidence supports, with many ascribing health benefits to marijuana despite insufficient evidence. The survey found extensive gaps in understanding the health effects and safety of marijuana use.
A recent study found that only 2% of trials assessing the safety or efficacy of probiotics, prebiotics, or synbiotics adequately reported key safety components. The researchers concluded that the lack of safety data makes it challenging to accurately determine their safety profile and make informed decisions for patients.
An expert panel has identified parallels between the current opioid epidemic and the early days of the HIV epidemic. The panel recommends five crucial steps for clinicians treating patients affected by opioid addiction and these intersecting infections, including increasing access to addiction care and developing hospital-based protocols.
A recent study published in Annals of Internal Medicine has found that cross-sex hormone therapy may increase the risk for certain vascular events among transgender women. The researchers compared the incidence rates of acute cardiovascular events in a large cohort of transgender persons with those observed in age-, race-, site-, and m...
Women with a history of preeclampsia or gestational hypertension in pregnancy developed chronic hypertension at a 2- to 3-fold higher rate than those with normal blood pressure. They also had significantly higher rates of type 2 diabetes and high cholesterol, highlighting the need for lifelong cardiovascular screening.
Researchers found no association between efavirenz and depression or suicidal ideation in Ugandan HIV patients. Efavirenz, a commonly used HIV cocktail worldwide, was previously linked to adverse psychiatric side effects in US and European populations.
Researchers found that combining elevated fasting glucose and HbA1c levels from a single blood sample is accurate for diagnosing diabetes. The new approach could prove useful in clinical practice by reducing patient visits and guiding treatment with HbA1c test results.
Researchers found that long-term viral suppression significantly reduces cancer risk in aging HIV-positive individuals, with lower rates seen in patients with sustained suppression compared to those with early or no suppression. The study highlights the importance of viral suppression in preventing cancer and may inform strategies for ...
Researchers developed an improved method for calculating risk for heart attack or stroke, finding that 11 million Americans may need to discuss different prescriptions with their doctor. The new calculations suggest major changes to statin, aspirin, and blood pressure medication prescribing, particularly for African Americans.
The American College of Physicians (ACP) has released a position paper calling for policies that better support women's health, including paid family and medical leave, reduced domestic violence, and access to reproductive services. A new prediction tool may also help tailor lung cancer screening to patient benefit and preferences.
Bioethicists from the National Institutes of Health suggest a framework for discussing the use of online genealogy data in crime-solving. The potential benefits are exciting, but issues must be addressed, including citizen rights and DNA evidence misuse.
Clinicians in safety-net hospitals feel morally distressed by policies preventing them from performing hemodialysis to undocumented immigrants, except in emergency situations. Emergency-only hemodialysis has a high mortality rate and is associated with burnout among clinicians.
Four risk prediction models have been shown to be most accurate for selecting the highest risk ever-smokers for lung cancer screening, suggesting that these findings can inform future lung cancer screening guidelines. The models picked similar numbers of ever-smokers and showed the best agreement on which ever-smokers to select.
Cancer remains a significant concern as the HIV-infected population ages. By 2030, prostate and lung cancers are projected to be the most common cancers among individuals with HIV, due to their weakened immune systems.
Automated BI-RADS breast density measures have similar predictive ability to clinical assessments, but may be more reproducible and suitable for identifying women at high risk of interval cancer. Hospital readmissions within the first week are more likely preventable than those occurring later, suggesting a shift in accountability model.
A randomized trial in Norway found that sigmoidoscopy screening reduced CRC incidence and mortality in men, but had little or no effect in women. Current guidelines recommending flexible sigmoidoscopy screening for women may need to be reconsidered. The effectiveness of screening in reducing colon cancer risk for women remains uncertain.
The American College of Physicians is calling for a revised approach to performance measurement, citing 32 valid and 30 invalid measures in Medicare's MIPS program. The ACP analyzed 86 performance measures and found that many were inadequately specified, leading to misclassification of high-quality care as low-quality care.
Researchers found that organs from overdose deaths have noninferior outcomes to those from trauma or natural death, but may carry higher risks of HIV and hepatitis transmission. Optimizing their use could help address the organ shortage, but caution is needed due to small potential risks.
Researchers found that oral sirolimus treatment significantly improved pulmonary function and reduced carcinoid tumor volume in three patients with DIPNECH syndrome. The study provides promising evidence for sirolimus as a viable treatment option for this rare condition.
A Zika vaccine has shown significant potential in eliminating prenatal infections, with a 75% effective vaccine covering 90% of females aged 9-49 years reducing incidence by at least 94%. The vaccine's effectiveness depends on demographic and fertility patterns, local Zika attack rates, and population susceptibility.
The American College of Physicians releases a new position paper advising physicians on ethical obligations when participating in short-term global health experiences. Key findings include the importance of partnering with local leaders and minimizing potential burdens on local communities.
A recent study found that e-cigarette users were less likely to abstain from tobacco at 6 months compared to non-users. However, this finding may not be representative of the general population, and more research is needed to determine the efficacy of e-cigarettes in smoking cessation.
A study of data from the National Health and Nutrition Examination Survey (NHANES) found that most Americans have suboptimal cardiovascular health. The study also revealed racial disparities in cardiovascular health, with rates of optimal health remaining below 40% for whites, 25% for Mexican Americans, and 15% for African Americans.
New research published in Annals of Internal Medicine found that gun laws in Australia stopped mass shootings altogether between 1996 and 2018, with no incidents reported during this period.
A new iPad app that educates patients about different options for colon cancer screening and allows them to order their preferred test has been shown to significantly increase screening rates. In a randomized controlled trial, patients who used the app were twice as likely to undergo screening compared to those in the usual care group.
The American College of Physicians (ACP) recommends less intensive blood sugar control targets for most patients with type 2 diabetes, aiming for an A1C range of 7-8% rather than 6.5-7%. This approach prioritizes symptom management over intensive treatment to balance benefits and harms.
The American College of Physicians recommends a moderate blood sugar control target of 7-8% for most patients with type 2 diabetes. Achieving this level balances long-term benefits with potential harms such as low blood sugar, medication burden, and costs.
Researchers found that literacy-adapted group cognitive behavior therapy (CBT) and simplified pain education (EDU) significantly improved pain and physical function in patients with chronic pain. The study suggests that CBT can be simplified to improve accessibility without reducing its potency.
The American College of Physicians recommends reinforcing formal curricula with hidden cultural lessons in medical education. This includes modeling empathy, encouraging reflection, and promoting learner and clinician wellness. The goal is to align positive hidden curricula with formal curricula and foster respect, inquiry, and honesty.
Researchers found hydroxychloroquine no more effective than placebo in relieving moderate to severe hand pain and radiographic osteoarthritis. The study's findings do not support the use of hydroxychloroquine as an alternative for patients with hand osteoarthritis, suggesting that tendon problems may be a major contributor to hand pain.
Researchers found a significant association between opioid use and the risk of laboratory-confirmed invasive pneumococcal diseases. High-dose opioids, especially those classified as high potency and long-acting formulations, were most strongly associated with invasive pneumococcal diseases in humans.
A recent study published in Annals of Internal Medicine found that consuming hot tea at high temperatures is associated with a significant increase in the risk of esophageal cancer. The research, which followed over 450,000 participants for nine years, suggests that abstaining from hot tea may be beneficial for individuals who drink al...
A systematic review found that living kidney donors have higher diastolic blood pressure, poorer renal function, and increased risk of end-stage renal disease. Female donors are at increased risk for preeclampsia and pregnancy-related complications.
Researchers found increased risk of congenital malformations with methimazole and propylthiouracil use during the first trimester. This association confirms the importance of minimizing MMI use in pregnancy and suggests reevaluating the current recommendation to switch from MMI to PTU.
A new report from NASEM outlines a framework for preventing alcohol-impaired driving fatalities. The framework includes highly effective interventions and emerging opportunities to reduce traffic-related deaths.
Researchers found that normal tissue BRCA1 methylation is associated with an increased risk of high-grade ovarian cancer, which may occur as a prenatal event. The study analyzed white blood cells from patients and healthy controls and discovered that elevated BRCA1 methylation was confined to those diagnosed with high-grade serous tumors.
A structured exercise program reduces major mobility disability in both frail and nonfrail patients, benefiting all older adults. Researchers found that physical activity can improve the ability to rise from a chair and reduce the risk of frailty.
Individualized risk-based lung cancer screening using calculators that account for demographic and clinical characteristics may save more lives than current USPSTF recommendations. Researchers estimate that this approach could have prevented over 5,000 more deaths in 2015 compared to the current guidelines.
Researchers found that team-based care with medication titration by a nonphysician clinician and physician leads to significant reductions in systolic blood pressure. Multilevel strategies without team-based care also show promise, reducing systolic blood pressure by 5 mm Hg.
A comprehensive review of published research found no proven intervention for preventing late-life dementia. Physical activity, prescription medications, cognitive training, and over-the-counter supplements were tested, but none showed significant effectiveness.
A new study published in Annals of Internal Medicine found that personalized blood glucose goals can save an estimated $234 billion nationwide over time, mainly due to lower medication costs. The approach also improves quality of life compared to uniform intensive control.