The American College of Physicians issues a guideline for treating nonradicular low back pain, recommending non-drug therapies such as superficial heat, massage, and acupuncture. For chronic low back pain, the ACP suggests exercise, multidisciplinary rehabilitation, and mindfulness-based stress reduction as initial treatment options.
The American College of Physicians recommends treating acute and subacute low back pain with non-pharmaceutical therapies like heat, massage, and spinal manipulation. For chronic low back pain, exercise, multidisciplinary rehabilitation, and acupuncture are shown to improve symptoms.
A long-term study found that e-cigarette users who stopped smoking cigarettes substantially reduced their intake of cancer-causing chemicals compared to those who continued to smoke. The study confirms that e-cigarettes are much safer than conventional cigarettes and may be a useful long-term quitting aid for patients.
A recent study by the American College of Physicians found that physicians spend significantly more time on computer activities than direct patient interaction, taking up about half their workday. This has led to concerns over physician satisfaction, patient education, and increased malpractice risks.
The ACA expanded insurance coverage and access to care for patients with chronic medical conditions, but nearly 1 in 7 remained uninsured. Home sleep testing was found to be as effective as lab testing in managing obstructive sleep apnea.
The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) have released a new guideline for treating hypertension in adults 60 years old and older. The guidelines recommend a less aggressive treatment target for otherwise healthy adults, with a focus on achieving a systolic blood pressure of less tha...
The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) recommend that physicians initiate treatment in adults aged 60 years old and older with persistent systolic blood pressure at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg. The guideline notes that some ...
A Danish cohort study found that breast cancer screening was not associated with a reduction in advanced tumors, but rather an increase in nonadvanced tumors and ductal carcinoma in situ (DCIS). The study estimates that approximately 1 in 3 invasive tumors diagnosed in screened women represent overdiagnosis.
The American College of Physicians recommends prescribing metformin as the primary treatment for type 2 diabetes when medication is necessary to improve blood sugar levels. Adding a second oral medication to metformin may provide additional benefits, but the cost should be discussed with clinicians and patients.
The analysis found that hospitals with lowest performance before implementing the law showed highest improvement in reducing readmission rates. Financial penalties under the Affordable Care Act led to significant reductions in hospital readmission rates for common conditions.
A systematic review of authoritative guidelines on sugar intake found that many recommendations are based on low-quality evidence. The review suggests that public health officials and consumers should be aware of these limitations when considering dietary sugar guidelines.
A population-based cohort study found that primary care physicians with higher ambulatory volumes deliver lower-quality diabetes care, while those with higher diabetes-specific volumes provide better care. The study's results suggest a clear association between physician volume and quality of diabetes management.
A national cohort study found that patients using more than one health system had significantly higher rates of potentially unsafe medication prescribing compared to those using the Department of Veterans Affairs (VA) only. The prevalence of such prescribing was particularly high among dual users, suggesting a need for improved coordin...
The American College of Physicians survey found that internists frequently prescribe high-cost treatments with little benefit to patients. Despite guidelines recommending against these practices, many physicians continue to use them, reflecting a desire to err on the side of treatment.
A systematic review found that achieving brain-type natriuretic peptide (BNP) and pro-brain-type natriuretic peptide (NT-proBNP) predischarge thresholds is associated with reduced mortality and readmission in patients hospitalized for acute decompensated heart failure. The evidence was low-strength, but the studies consistently showed ...
A randomized clinical trial found that long-term collaborative care and occupational therapy did not slow functional decline in persons with Alzheimer disease. The study suggests that new assistive devices, home modifications, and technologies are needed to support patients and families at home.
Testing for HPV types 16 and 18 in women with minor cervical lesions may help determine which patients should be referred to colposcopy. This approach could lead to more precise patient management and reduced healthcare burden.
Despite decades of improved survival rates, childhood cancer survivors continue to report poor physical and mental health status. Researchers found that patients treated in earlier decades had better health outcomes than those treated in later decades, suggesting a link between access to follow-up care and reported adverse outcomes.
The American College of Physicians recommends using corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout. The guideline also emphasizes the importance of diagnosing gout accurately to prevent misdiagnosis and unnecessary treatment. Additionally, researchers found that industry-...
The American College of Physicians recommends using corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout. The guideline also advises against long-term uric acid-lowering therapy in most patients after a first gout attack.
The new evidence-based clinical guideline from the National Osteoporosis Foundation and American Society for Preventive Cardiology says that calcium with or without vitamin D intake should be considered safe for generally healthy adults. Obtaining calcium from food sources is preferred, but supplements can be used to address dietary sh...
HIV-infected patients with chronic HBV and HCV coinfection are at a higher risk for non-Hodgkin's lymphoma, a leading cause of AIDS-related deaths. The study found that the incidence rate is 10 times higher in HIV-infected persons compared to the general population.
Former USPSTF chairs, Virginia A. Moyer, Michael LeFevre, and Ned Calonge, suggest that guidelines should only inform, not dictate, insurance coverage decisions. They cite Mylan's attempt to influence the panel as a flawed example of this issue.
Copay assistance programs are a Band-Aid on the problem of high drug prices. Experts argue that these programs actually drive up healthcare costs and limit access to essential medications. To mitigate this impact, policymakers should redirect their focus towards innovation incentives, not just cost containment.
Researchers have identified three objective criteria to quickly identify patients with zero chance of survival from out-of-hospital cardiac arrest (OHCA) who can be considered for organ donation. These criteria include lack of witness emergency medical services personnel, nonshockable initial cardiac rhythm, and failure to return spont...
Physician burnout may be linked to heavy electronic health record (EHR) use. A recent study found that doctors spend nearly two additional hours on EHRs for every hour spent directly caring for patients, contributing to their physical and mental exhaustion. The burden of EHRs is a significant concern in the medical field.
Researchers found sacubitril-valsartan to be a cost-effective treatment option for patients with reduced ejection fraction heart failure, resulting in improved quality of life and reduced hospitalizations. The therapy offers incremental benefits at a lower cost than previously thought.
Breast density and risk can inform decision to adjust mammogram screening frequency; average-risk women with lower breast density may safely extend screening interval to once every three years. Higher-risk women with dense breasts would reap greater benefit from annual screening, according to the American College of Physicians.
Researchers found that immunizing children with the flu nasal spray did not provide better direct or community protection against influenza than the inactivated influenza vaccine, but offered similar protection. This contradicts earlier studies suggesting the nasal spray vaccine provided better herd immunity.
Research suggests removing drug use barriers to effective hep C treatment for opioid-addicted patients. The elbasvir-grazoprevir treatment showed high sustained virologic response rates in a randomized trial. In contrast, lipid screening evidence is lacking for younger adults.
Researchers found that patients with nonfunctional adrenal tumors have a significantly higher risk for developing diabetes compared to those without the condition. The study suggests that these tumors may warrant more clinical attention and should be considered an independent risk factor for diabetes.
According to a study published in Annals of Internal Medicine, travelers to Brazil during the 2016 Olympics are at low risk of contracting or spreading Zika virus. The World Health Organization advised that non-pregnant travelers can safely attend events while taking precautions.
A high-fat Mediterranean diet with no restrictions on fat intake may reduce the risk of breast cancer, diabetes, and cardiovascular events. The diet's monounsaturated-to-saturated fat ratio, fruit and vegetable intake, and moderate red wine consumption are key components that contribute to these benefits.
A randomized controlled trial found that changes in pain and physical function did not differ between patients wearing unloading shoes or conventional walking shoes. The study suggests that choosing one type of shoe over the other may not significantly impact symptoms for knee osteoarthritis sufferers.
Having a first-degree relative hospitalized with confirmed staph infection significantly increases the risk for microbiologically confirmed Staphylococcus aureus bacteremia. The risk is higher if the infected patient is a sibling than a parent, according to researchers who analyzed data from Denmark.
A new study published in Annals of Internal Medicine found that coprescribing naloxone with opioids for chronic pain can significantly reduce opioid-related emergency room visits. The study also showed that patients prescribed naloxone had substantially fewer overdose episodes compared to those not prescribed the medication.
Researchers found that several commercially available tests for hepatitis C virus core antigen are highly sensitive and specific, potentially replacing the current two-test screening process with a single test. This could streamline care in low- and middle-income countries where HCV is prevalent, but patients are often lost to follow-up.
Researchers found that at least one in five elderly nursing home residents experienced resident-to-resident mistreatment, with verbal aggression being the most common form. The study's findings highlight a need for better understanding and prevention strategies for this type of abuse.
A study found that Army personnel were most at risk for violent suicide among active duty enlisted service members. Firearms accounted for 62% of suicides with a known cause of death. The results suggest that infantry and special operations job classifications may be more likely to use firearms to commit suicide.
Achieving the 90-90-90 targets for HIV diagnosis, treatment and virologic suppression in South Africa would have a transformative impact, averting millions of new infections, saving millions of lives and preventing orphanages. The initiative is estimated to yield enormous population and clinical benefits.
A prospective economic study published in Annals of Internal Medicine found that computed tomographic angiography and functional diagnostic testing strategies for diagnosing coronary artery disease have similar costs through 3 years of follow-up. The study included 9,649 patients enrolled in a clinical trial between 2010 and 2013.
Physicians can ask patients about firearms, counsel them on gun safety, and disclose information to third parties as needed. Current federal and state statutes do not prohibit discussing firearms with patients, but many physicians lack training and knowledge to provide effective counseling.
Cardiovascular magnetic resonance (CMR) is a stronger predictor of risk for major adverse cardiovascular events (MACE) than single-photon emission computed tomography (SPECT). CMR has higher sensitivity and negative predictive value compared to SPECT, making it a robust alternative for diagnosing coronary heart disease.
Cognitive behavioral therapy is recommended as first-line treatment for adults with chronic insomnia, according to the American College of Physicians. The new guideline also suggests a shared-decision making approach if therapy alone is unsuccessful, and notes that medication may have fewer harms than sleep medications.
The American College of Physicians (ACP) endorses cognitive behavioral therapy for insomnia (CBT-I) as the primary treatment for adults with chronic insomnia. CBT-I combines cognitive therapy around sleep with various behavioral therapies.
A national PrEP program for injection drug users is cost-prohibitive due to high drug prices, but investing in naloxone therapy, medical insurance, and detoxification programs could prevent HIV infections more effectively. The study suggests that alternative approaches may be a better use of HIV prevention resources.
Climate change will have devastating consequences for public and individual health unless aggressive, global action is taken to curb greenhouse gas emissions. ACP recommends that medical schools incorporate climate change-related coursework into curricula.
The American College of Physicians calls for immediate global action to combat the health impacts of climate change, including heat-related illnesses and malnutrition. A new policy paper highlights the need for physicians to educate themselves and their patients about climate change's effects on human health.
The USPSTF recommends taking low-dose aspirin for primary prevention of cardiovascular disease and colorectal cancer in adults aged 50-69 years with increased risk. Aspirin use can outweigh harms for some patients, including those at high risk for CVD, improving life expectancy and quality of life.
Patients undergoing parathyroid surgery experienced fewer hip fractures and fractures of any type compared to those receiving bisphosphonates. Surgery also improved bone mineral density, while bisphosphonates had no impact on fracture risk.