The American College of Physicians, along with the American Pharmacists Association and The Gerontological Society of America, has released a new resource highlighting the biological impact of aging on immunity. The guidebook emphasizes the importance of adult immunization in preventing age-related decline in immunity.
A recent study published in Annals of Internal Medicine found that cocaine overdose deaths disproportionately impact the non-Hispanic black population, with rates comparable to those for heroin and prescription opioid-related deaths. The research highlights the need for targeted prevention efforts among this demographic.
Naloxone administered in the field by EMS personnel is safe and effective for reversing opioid overdose symptoms, according to a systematic evidence review. Research is needed to determine the optimal dose and route of administration.
The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) advise physicians to vaccinate all unvaccinated adults against hepatitis B virus (HBV) infection and screen high-risk persons. This can help reduce chronic HBV infections, cirrhosis, hepatocellular carcinoma, and premature death.
The American College of Physicians and Centers for Disease Control and Prevention recommend screening at-risk adults, increasing hepatitis B vaccination rates, and linking infected persons to care. This can help reduce transmission and complications associated with chronic hepatitis B infection.
A study of middle-aged adults found that functional impairment was common among the cohort and often progressed to further physical decline or death over a 10-year follow-up. The findings challenge the notion that functional impairment is temporary in middle age and suggest a need for early intervention.
A phase 4 randomized clinical trial found that self-administered treatment for latent tuberculosis infection had a high rate of treatment completion in the United States, Spain, and Hong Kong. The findings suggest that once-weekly isoniazid and rifapentine by self-administration is noninferior to direct observation in completing treatm...
A nationwide population-based study found that death rates from lupus remain high compared to the general population, with significant disparities observed among older persons, females, blacks, and Hispanics. The study suggests that targeted research and public health programs may help address these disparities.
A study published in Annals of Internal Medicine found that gun-related deaths and injuries in neighboring California spiked by nearly 70 percent after gun shows were held in Nevada. The findings suggest that lack of federal gun legislation reduces the impact of state laws intended to protect citizens from firearm injury and death.
A study by the American College of Physicians found that almost 11 million US men have oral human papillomavirus (HPV) infection, with a high prevalence among men with multiple lifetime oral sex partners and those who report having sex with men. HPV causes various cancers, including oropharyngeal squamous cell carcinoma, which dispropo...
The American College of Physicians urges physicians to make a public commitment to talk to their patients about firearms and counsel them on safe firearm behaviors. Physicians who commit to this action can find resources and information in the growing literature.
Many opioid dosage combinations have no prescribing restrictions under Medicare formulary, suggesting an opportunity to limit opioid prescribing. Restricting coverage for prescription drugs is one strategy to decrease opioid prescribing.
A new tool using readily available data accurately estimates the 30-day mortality risk for patients admitted to the emergency department with acute heart failure. This tool can inform clinical decisions and improve patient outcomes.
A study published in Annals of Internal Medicine found that hospital mortality rates after heart attack vary by age, with older and younger patient groups showing different outcomes. The Centers for Medicare & Medicaid Services currently only considers data for patients aged 65 or older when calculating hospital quality ratings.
The American College of Physicians opposes the legalization of physician-assisted suicide, citing ethical concerns and a focus on improving hospice and palliative care. The organization recommends 12 steps for physicians to provide compassionate supportive care to patients nearing the end of life.
The American College of Physicians (ACP) has reaffirmed its opposition to the legalization of physician-assisted suicide, citing ethical and clinical concerns. ACP emphasizes the importance of improving palliative care, including awareness and access, as a more effective approach to end-of-life care.
A study published in Annals of Internal Medicine found that excessive sedentary time, regardless of exercise habits, significantly increases the risk of death. Taking regular movement breaks can help mitigate this effect.
Guidelines recommending against routine PSA-based screening may be revised due to compatible evidence showing screening reduces prostate cancer mortality. The benefits of screening outweigh potential harms of overdiagnosis and overtreatment, but how to implement screening is still a question.
A recent study published in Annals of Internal Medicine found that neighborhood socioeconomic position is a crucial predictor of cardiovascular risk. The model used to predict this risk systematically underestimated the negative effects of living in disadvantaged neighborhoods, highlighting the importance of considering ecologic circum...
A re-analysis of USPSTF evidence suggests flexible sigmoidoscopy may reduce all-cause mortality, contrary to previous guidelines. Researchers found that looking at cohorts as separate trials, rather than aggregating them, strengthened the evidence supporting screening with flexible sigmoidoscopy.
The scientific evidence on cannabis for chronic pain and post-traumatic stress disorder (PTSD) is inconclusive, with only low-strength evidence suggesting potential benefits. However, researchers found significant risks associated with cannabis use, including increased risk of motor vehicle accidents and psychotic symptoms.
A systematic review and meta-analysis found that both bisphosphonates and denosumab improve bone mineral density in men with nonmetastatic prostate cancer receiving androgen deprivation therapy. Further trials are needed to confirm fracture reduction outcomes.
A substantial number of US adults reported misusing prescription opioids, with 11.5 million admitting to misuse and 1.9 million having a use disorder. The majority of these individuals had low income or behavioral health problems, while relief from physical pain was the most common motivation for misuse.
The American College of Physicians states that internet-driven pseudoscience is a major contributor to low statin adherence rates, despite their well-documented benefits. Continuing statin prescriptions after adverse reactions may reduce cardiovascular events and death risk.
Dose reduction in long-term opioid therapy for chronic pain improves pain, function, and quality of life. Multidisciplinary pain programs incorporating behavioral interventions can enhance patient outcomes.
Two large studies published in Annals of Internal Medicine suggest that higher coffee consumption is associated with a lower risk for death, particularly among whites and non-white populations. The studies found that moderate to high coffee intake was linked to reduced mortality rates for diseases such as digestive tract disorders and ...
Researchers found that generic drug prices rose significantly when market competition decreased, particularly in lower-priced drugs. The study suggests understanding the connection between competition and price may help identify older prescription drugs at higher risk for price changes in the future.
A review of published evidence shows that having health insurance significantly reduces the risk for death. The study also found that health insurance improves self-rated health and financial protection, and reduces the likelihood of depression.
A pilot randomized trial found that about 22% of generally healthy adult patients with whole genome sequencing results had a previously unrecognized variant with potential risk for a rare Mendelian disease. However, only about 4% had a clinically relevant abnormality related to a variant.
A study of 320 predominantly low-income, racially diverse adults with chronic low back pain found that yoga was as safe and effective as physical therapy in restoring function and relieving pain. Yoga and physical therapy groups showed similar improvements at 1 year, suggesting a reasonable alternative for patients.
Researchers found that HbA1C levels are higher in blacks compared with whites for a given mean glucose level, suggesting racial differences in glycation of hemoglobin. This discrepancy highlights the need for clinicians to individualize care based on blood glucose levels rather than relying solely on HbA1C levels.
Researchers found that small and very small unruptured intracranial aneurysms have low growth rates, ranging from less than 3% per year. The annual rupture rate for aneurysms smaller than 7mm was 0-1%. These findings may inform patient management and treatment decisions for patients with UIAs.
The study suggests that patients with rheumatoid arthritis should use a combination of drugs known as triple therapy instead of biologic therapy, due to the high costs involved. The analysis found that triple therapy is as effective as switching directly to biologics, but at a significantly lower cost.
A study found that black persons are 31% more likely than white persons to develop interval colorectal cancer, a type of cancer that develops after a negative colonoscopy result. The risk is highest for distal colon and rectal cancer, and is not explained by differences in physician quality.
More than half of eligible US travelers fail to receive a pre-trip measles vaccine, despite clinical recommendations. This increases the risk of endemic measles outbreaks in the US. Researchers urge improved provider and traveler knowledge of measles as a travel-related illness and increased vaccination rates.
The American College of Physicians strongly recommends the use of generic bisphosphonates or denosumab to reduce fracture risk in women with osteoporosis. The guideline advises physicians to prescribe generics over brand-name drugs and discuss medication adherence with patients.
The American College of Physicians recommends treating women with osteoporosis with bisphosphonates or denosumab, while men may also benefit from treatment to reduce vertebral fracture risk. The guideline emphasizes the importance of medication adherence and avoids estrogen therapy due to its associated risks.
Following mass shootings, there are sharp increases in handgun acquisitions in California, with significant spikes seen among white and Hispanic persons. Researchers suggest this may lead to substantial increases in firearm ownership.
Using HEART score to risk stratify patients with chest pain is safe and effective. However, its underutilization in emergency department (ED) settings may contribute to its limited impact on healthcare costs, which could be improved by reducing unnecessary admissions and testing.
A high-sensitivity troponin T test can safely rule out myocardial infarction (MI) in patients presenting to emergency departments with possible acute coronary syndrome. The test, combined with a non-ischemic electrocardiogram, indicates low risk for MI and allows for safe discharge of patients.
Research on osteoporosis medications in patients with chronic kidney disease (CKD) found mixed results regarding benefits and harms. Bisphosphonates may slow BMD loss but effects on fractures and safety are unclear. More research is needed to determine the best options for patients across CKD spectrum.
A study published in Annals of Internal Medicine found that being overweight at any point in adulthood increases the risk of death from various causes, including cardiovascular disease and cancer. Researchers analyzed weight history over 16 years and found that people with a maximum BMI in the overweight or obese categories were at ele...
The journal highlights several notable research findings, including the benefits of quitting smoking abruptly, low-dose aspirin for cardiovascular prevention, and statins in rheumatoid arthritis. These updates aim to promote excellence in medicine and improve patient outcomes.
The American College of Physicians recommends treating substance use disorders as chronic medical conditions with evidence-based public and individual health initiatives. The guidelines aim to improve access to care and reduce the societal burden of these disorders.
The American College of Physicians (ACP) issues recommendations for preventing and treating substance use disorders involving illicit and prescription drugs. Key findings include limited access to care, with only 18% of those needing treatment receiving it, and the need for expanded public health initiatives and improved prescribing pr...
Oral direct-acting antiviral (DAA) regimens produce high sustained virologic response rates for all six hepatitis C virus (HCV) genotypes, making them effective for treating patients with chronic HCV infection. The ease of dosing and safety profile of DAAs provide an opportunity to reduce the burden of hepatitis C in the US.
A study published in Annals of Internal Medicine found that Canadians with cystic fibrosis have a significant survival advantage over American patients, with a median age of survival of 50.9 years compared to 40.6 years in the US. The difference is attributed to better healthcare coverage and nutrition in Canada.
A randomized, placebo-controlled trial found that anakinra did not reduce fatigue severity in women with chronic fatigue syndrome. The study's findings suggest that interleukin-1 inhibition may not play a role in CFS, contradicting previous studies.
Under the PAMA provision, physicians will need to consult CMS-approved computer-based clinical decision support mechanisms when ordering advanced imaging procedures. The CMS will collect data for two years before implementing prior authorization for 'outlier' physicians, which may limit access to these procedures.
Researchers found that a telephone-based weight loss program combined with a maintenance intervention slowed the rate of weight regain in obese outpatients. The study suggests that incorporating weight maintenance interventions into clinical programs could make them more effective over the long term.