A systematic review of published evidence found that extended dual antiplatelet therapy (DAPT) decreases the risk for myocardial infarction but increases major bleeding events and may increase mortality. The authors suggest based on patient preferences after discussing benefits and harms.
The American College of Physicians recommends screening for five common cancers: breast, colorectal, ovarian, prostate, and cervical. High-intensity screening may do more harm than good due to over-diagnosis and overtreatment. ACP advises focusing on tests that improve health and avoid harms.
A study published in Annals of Internal Medicine suggests that women with extremely dense breasts do not necessarily need additional imaging after a normal mammogram. However, those with high-risk dense breasts should discuss supplemental screening strategies with their doctors. The American College of Physicians advises 'smarter' canc...
The American College of Physicians recommends comprehensive transgender health care services in health benefits plans and civil marriage rights for same-sex couples. The organization also opposes 'conversion' therapy and aims to eliminate disparities in healthcare access for LGBT individuals.
A case report suggests that taking an unlabeled stimulant like BMPEA in a sports supplement combined with exercise can cause a hemorrhagic stroke. The patient reported sudden numbness and clumsiness after exercising, highlighting the potential risks of untested stimulants in dietary supplements.
Research found that patients with type 2 diabetes who are overweight but not obese live longer than those who are underweight or normal-weight. The 'obesity paradox' suggests that excess weight may be beneficial for survival in these patients, contrary to previous expectations. Meanwhile, daily low-molecular-weight heparin injections w...
The American College of Physicians (ACP) has released best practice advice for cervical cancer screening, supported by ACOG and ASCP. The guidance aims to reduce overuse of screening in average-risk women without symptoms.
The American College of Physicians (ACP) recommends starting cervical cancer screening at age 21 every three years with cytology tests, and using a combination of cytology and HPV testing every five years for women aged 30 and older. ACP advises stopping screening for women over 65 with negative test results within the past 10 years.
A new class of PCSK9 antibodies has been shown to reduce mortality, lower LDL-cholesterol, and improve cardiovascular outcomes in patients with dyslipidemia. The treatment was well-tolerated and proved safe, providing a promising alternative for those who do not respond to statins.
The study demonstrates a new therapeutic option for chronic HCV infection, achieving high sustained virologic response rates. The combination therapy resulted in 90% sustained viral response (SVR12) rates across various genotypes of the virus.
The American College of Physicians recommends banning characterizing flavors and television advertising for e-cigarettes to reduce their appeal. Statins are found to be cost-effective for older patients, but even small increases in adverse effects could offset the benefits.
The USPSTF completed a systematic evidence review to inform an upcoming update of Task Force recommendations on screening asymptomatic adults for type 2 diabetes. Screening was found to help delay progression to diabetes by identifying those who could benefit from treatment, but did not improve mortality rates.
Researchers found that Weight Watchers and Jenny Craig are the most effective commercial weight-loss programs for long-term weight loss. In contrast, physical therapy was as effective as surgery in alleviating symptoms of lumber spinal stenosis. Leading internists also advocate for a more thoughtful approach to cardiopulmonary resuscit...
The US Preventive Services Task Force has updated its recommendations on iron supplementation and screening in pregnant women, finding that routine iron supplementation during pregnancy may reduce the incidence of iron deficiency and anemia. In contrast, new hepatitis C treatments show promise but may exceed insurers' willingness to pa...
The US Preventive Services Task Force finds that routine screening for thyroid dysfunction in nonpregnant, asymptomatic adults lacks sufficient evidence. In contrast, the American Diabetes Association recommends individualized treatment plans for patients with diabetes, taking into account factors like age, comorbid conditions, and car...
The American College of Physicians recommends avoiding cardiac screening in low-risk adults, citing lack of benefits and potential harms. Instead, physicians should focus on treating modifiable risk factors such as smoking, diabetes, and hypertension.
The American College of Physicians recommends against routine cardiac screening for low-risk adults, citing insufficient evidence and potential harms. Instead, physicians should focus on mitigating cardiovascular risk through treating modifiable factors like smoking and hypertension.
A study published in Annals of Internal Medicine found that the appropriate use criteria for diagnostic cardiac catheterization may not be reliable for guiding clinical decisions. The researchers evaluated a cohort of 48,336 patients without a history of coronary artery disease and found that obstructive CAD is more likely to be diagno...
Researchers found that both low-intensity and high-intensity workouts are effective for weight loss, with higher intensity associated with improved glucose levels. Participants in the high-intensity exercise group experienced significant reductions in waist circumference and two-hour glucose levels.
A study published in Annals of Internal Medicine found that female medical students are as accurate as their male counterparts but report less confidence in their abilities. This confidence gap could be addressed through improved medical training, helping to enhance physician competency and reduce defensive medicine practices.
The American College of Physicians has released new guidelines for preventing and treating bedsores, recommending protein supplementation and hydrocolloid dressings to reduce wound size. Advanced static mattresses and overlays are also recommended for patients at increased risk, while alternating air mattresses and overlays are advised...
Eight health professional organizations and the American Bar Association recommend reducing firearm-related injuries and death in the US through public health approaches. They advocate for criminal background checks, improved access to mental health care, and research into firearm violence causes.
The American College of Physicians and seven national health organizations, along with the American Bar Association, urge policymakers to implement measures reducing firearm-related harm. The organizations support a public health approach to address firearm injuries and fatalities.
Researchers found a simple fiber-rich diet to be nearly as effective as the American Heart Association (AHA) diet for weight loss and improving metabolic health. However, AHA diet's many rules may make adherence challenging for some. Meanwhile, clinical risk calculators seriously overestimate heart attack risk. Sore throats in young ad...
A new report from the Institute of Medicine proposes revised diagnostic criteria for chronic fatigue syndrome, highlighting its physiologic nature. The criteria also emphasize the debilitating symptom of post-exertional malaise, where exertion triggers prolonged periods of fatigue.
Using Lung Imaging Reporting and Data System (Lung-RADS) criteria may reduce false positives in low-dose CT lung screenings by raising the nodule size cutoff. However, this comes at the cost of reduced sensitivity.
A study found that an oral supplement containing arginine, zinc, and antioxidants improves healing of mild to severe pressure ulcers in malnourished patients. Meanwhile, a survey suggests that pain and other alarming symptoms in the last year of life have increased from 1998 to 2010. The Centers for Disease Control and Prevention's ACI...
The American College of Physicians marks its centennial year with a focus on the role of internal medicine in healthcare systems, professional satisfaction, and cost control. The journal also explores the challenges of sharing clinical trial data, highlighting the need for a consistent approach to balance benefits and risks.
A systematic review found that prolonged sitting is independently associated with negative health outcomes and mortality, especially among those who exercise little. Tips from the author include taking regular breaks to stand or move around, setting achievable goals for reducing sedentary time.
A recent NIH report warns of dose-dependent risks of long-term opioid therapy, while an ACP policy paper tackles clinical documentation in electronic health records. These guidelines aim to improve care and documentation practices among healthcare professionals.
A systematic evidence review found that several common treatments for knee osteoarthritis are effective for pain relief, with injectable therapies being the most effective. The review also introduced a new reporting guideline called TRIPOD to improve the quality of reporting in published articles describing prediction model studies.
Medical ethicists offer guidance on life-sustaining therapies for Ebola patients in developed countries, balancing risks and benefits. Former Surgeon General David Satcher discusses the importance of credibility and influence in the role, emphasizing scientific evidence-based reports.
A systematic review published in Annals of Internal Medicine suggests that blood pressure-lowering therapy can reduce stroke, cardiovascular deaths, and total deaths in patients with mild hypertension. Ambulatory monitoring may also improve the diagnostic accuracy of office screening for high blood pressure.
Researchers found that black patients' poorer health at diagnosis, not treatment differences, explains most of the racial disparity in colon cancer survival. Emphysema detected on CT scans is linked to increased mortality among those without airflow obstruction or COPD.
A new study published in Annals of Internal Medicine found that breast density notification laws substantially increase costs and save relatively few lives. The study suggests that these laws would result in limited health gains and substantially increased expenses.
Researchers found that having diabetes in midlife may protect against cognitive decline later in life, while living in a socioeconomically disadvantaged neighborhood increases the risk of rehospitalization. Additionally, sharing patient health information through health information exchange reduces ER visits and costs.
The US Preventive Services Task Force concludes that current evidence is insufficient to assess the benefits and harms of routine screening for vitamin D deficiency. Researchers found no direct evidence on the effects of screening versus no screening, but treating patients with low serum levels may help prevent adverse outcomes.
Researchers found that smartphone apps designed for weight loss were unlikely to produce substantial weight loss in obese patients, highlighting the need for more engaging and time-efficient tools. Meanwhile, a study showed that offering a one-in-ten chance of winning $50 increased colon cancer screening rates by 20% compared to other ...
Researchers warn of increased bleeding risk from NSAIDs in atrial fibrillation patients and suggest alternative pain medications. Additionally, a study finds three in ten adults with diabetes remain undiagnosed, highlighting the need for improved care improvements.
The American College of Physicians recommends a systematic approach to discussing end-of-life care goals with patients, aiming for better quality of life and longer survival rates. The guidelines also highlight the importance of training clinicians, identifying at-risk patients, and using structured communication formats.
A new set of guidelines for platelet transfusion aims to reduce bleeding in adult patients, while a multidrug regimen shows higher remission rates for lupus nephritis patients in a randomized controlled trial.
The American College of Physicians recommends increasing fluid intake to at least two liters per day to prevent kidney stone recurrence. A new guideline also suggests dietary changes, including reducing oxalate and animal protein consumption, to help prevent stone formation. Sofosbuvir plus ledipasvir has shown promise in re-treating H...
The American College of Physicians recommends increasing daily fluid intake to at least two liters to reduce kidney stone recurrence. Additionally, medication with a thiazide diuretic, citrate, or allopurinol can effectively reduce stone recurrence in patients with calcium stones.
Researchers developed a random transmission model to determine how disease progression and case fatality affect transmission and patient isolation. Isolating the sickest Ebola-infected individuals before they progress into their late phase of illness can effectively eliminate the Ebola epidemic in Liberia.
Researchers suggest that asymptomatic individuals may benefit from treatment for thyroid dysfunction to reduce associated health risks. However, the effectiveness of thyroid screening is still unknown, and further studies are needed to inform an updated recommendation.
Researchers developed the 3D-CAM test, a short and structured diagnostic assessment to diagnose delirium. The test was highly sensitive and specific, with a sensitivity rate of 96% and specificity rate of 98%. Additionally, a study found that clinicians often remain unaware of patients' central venous catheters in place, posing a patie...
Experts warn conventional US medical centers may struggle to manage Ebola due to lack of preparedness and training. Regional referral centers could help address the shortage of high-level biocontainment patient facilities.
A study published in Annals of Internal Medicine found that medical residents' knowledge of High Value Care is essential for patient outcomes. The study used the IM-ITE exam and a hospital care intensity index to assess resident knowledge, revealing that conservatively managing patients was a key competency.
A commentary cautions against using experimental Ebola drugs without proper triage to minimize risks. Meanwhile, health economists highlight a major flaw in the FDA's cost-benefit analysis of proposed cigarette labeling regulations. Additionally, a national study reveals that medical residents have varying levels of knowledge on High V...
The first article suggests that physicians can steer eligible defendants into treatment programs instead of correctional facilities, while the second article advocates for fair hiring practices in hospitals to improve the health and wellbeing of former inmates. Both articles emphasize the importance of addressing social issues such as ...