Commentaries in Annals of Internal Medicine argue that Proposition 46's mandatory physician drug testing could deter help-seeking and reporting, potentially harming patients. The authors instead advocate for addressing physician impairment through more nuanced solutions.
The USPSTF recommends intensive behavioral counseling to reduce risky sexual behaviors among all sexually active adolescents and adults at risk for STIs. Chlamydia and gonorrhea screening is recommended for young women under 24 and older women at increased risk, including pregnant women.
The American College of Physicians recommends Kegel exercises, bladder training, and weight loss as effective treatments for stress and urgency urinary incontinence. Non-surgical treatment options are recommended over medication to minimize side effects and costs.
The American College of Physicians (ACP) recommends Kegel exercises, bladder training, and weight loss as effective nonsurgical treatment options for women with urinary incontinence. Generic statins are also shown to improve adherence to medication and clinical outcomes compared to brand-name drugs. Chiropractic care coupled with exerc...
A secondary analysis of the National Lung Screening Trial (NLST) data found that both cancer prevalence and positive predictive value of lung cancer screening were higher in the 65+ cohort than in the under-65 cohort. Clinicians should share age-specific estimates of screening benefits and harms with patients to make an informed decision.
The American College of Physicians (ACP) advises pregnant women at high risk for preeclampsia to take daily low-dose aspirin. Meanwhile, a study found that health insurance remains unaffordable for many younger adults under the Affordable Care Act, with premiums often exceeding the cost of purchasing a plan.
A low-carbohydrate diet is more effective than a low-fat diet in reducing body weight and cardiovascular risk factors. The study found that participants on a low-carb diet experienced greater decreases in weight, fat mass, and other cardiovascular risk factors compared to those on a low-fat diet.
The US Preventive Services Task Force recommends intensive behavioral counseling for overweight and obese patients with at least one additional risk factor for cardiovascular disease. This intervention helps individuals lose weight and improve their lipid levels, blood pressure, and glucose levels.
A commentary published in Annals of Internal Medicine highlights two factors contributing to Ebola infection among healthcare workers: insufficient supply of personal protective equipment and inadequate donning/doffing procedures. To prevent transmission, the authors recommend a structured process for gear removal.
Two commentaries in Annals of Internal Medicine emphasize the need for immediate Ebola vaccine deployment and cautious approach to containment plans. The authors argue that safety risks from vaccines are negligible compared to healthcare worker risks, while excessive measures can foster mistrust and increase risk.
Two American missionaries who contracted Ebola virus in West Africa deserve special treatment for their selfless act of caring for infected patients. The author argues that limiting experimental treatment to these two patients is necessary due to the ethical concerns of exploiting vulnerable individuals during a public health outbreak.
A commentary published in Annals of Internal Medicine reveals the history of 'miraculous' Ebola virus serotherapy, inspired by 19th century discoveries. Additionally, two systematic reviews address challenges of interpreting troponin levels in patients with chronic kidney disease.
The American College of Physicians recommends a full-night sleep study for patients with unexplained daytime sleepiness to diagnose obstructive sleep apnea. Obesity is the best documented risk factor for OSA, and symptoms include snoring, daytime sleepiness, and fatigue.
The American College of Physicians recommends a full-night polysomnography test for diagnosing obstructive sleep apnea. A computer model predicts that new therapies will make chronic hepatitis C a rare disease by 2036. Physical therapy and corticosteroid injections provide equal relief from shoulder pain and disability, with MPT patien...
A study found that early initiation of menopausal hormone therapy has a neutral effect on atherosclerosis progression in women. Meanwhile, the effectiveness of decision aids for advanced care planning is unclear due to limited research. Additionally, recent safety lapses at government labs pose a bioterror risk, highlighting the need f...
Hospital performance measures must be adjusted to consider patient sociodemographic status factors or disparities in outcomes and access. Long-term remission of HIV returns after patients stop antiretroviral treatment through allogeneic hematopoietic stem cell transplantation, but virus rebounds when therapy is restarted.
Research shows that pill appearance can affect how patients take their medications, with a study finding that 30% of heart patients who stopped taking their medication had changed pill color or shape beforehand. In contrast, having strong social ties is associated with lower rates of suicide death among men, according to another study.
The US Preventive Services Task Force recommends against screening for asymptomatic carotid artery stenosis due to its high rate of false positives. A systematic review found no evidence that screening improves outcomes, but also identified a small risk of harms such as stroke and mortality.
The American College of Physicians recommends against routine pelvic exams for asymptomatic, average-risk women due to low diagnostic accuracy and potential harms. The guideline suggests that pelvic exams are appropriate only for women with symptoms or certain risk factors.
The American College of Physicians recommends against routine pelvic examinations for asymptomatic, average-risk non-pregnant women due to the lack of demonstrated benefit and potential harms. In contrast, the guideline suggests Pap smear screening without a bimanual examination, recommending visual inspection of the cervix, cervical s...
The US Preventive Services Task Force recommends annual screening for abdominal aortic aneurysms in men aged 65-75 who have ever smoked, while cautioning against widespread lung cancer screening among high-risk older adults due to insufficient evidence. The committee cited age-related risks and diminishing benefits of extended life fro...
The American College of Physicians recommends assessing a woman's health history for unique events that increase her risk of stroke later in life. For chronic hepatitis C patients, routine screening for liver cancer may not lead to greater survival.
Increasing cervical cancer screening rates can help prevent invasive cancer. Experts recommend focusing on population coverage rather than choosing a specific test. Meanwhile, the release of Medicare data provides insights into healthcare spending and quality, but lacks meaningful context for evaluation.
Colorectal cancer screening should continue beyond age 75 for previously unscreened patients, according to new guidelines. Practices that implement a patient-centered medical home model with electronic health records (EHRs) have shown improved quality of care compared to non-PCMH practices.
The USPSTF recommends screening for hepatitis B virus (HBV) in nonpregnant high-risk adolescents and adults, as well as postnatal immunoprophylaxis to prevent maternal transmission. Studies have shown that these interventions can reduce mortality and hospital readmissions related to heart failure.
The US Preventive Services Task Force found insufficient evidence to recommend for or against screening for suicide risk in adolescents, adults, and the elderly. However, healthcare professionals should consider referring patients with risk factors or high emotional distress for further evaluation. On the other hand, vaccination during...
A study published in Annals of Internal Medicine found that Massachusetts' comprehensive health care reform led to a significant decline in deaths, particularly among nonelderly residents. The researchers estimated that the reform prevented 320 deaths per year and saved one life for every 830 persons gaining insurance. Additionally, th...
The updated 2014-2016 HHS Viral Hepatitis Action Plan aims to tackle rising incidences of liver disease and cancer caused by untreated chronic viral hepatitis. The plan builds on previous goals but expands evaluation metrics, calling for further commitments to decrease morbidity and mortality.
A recent measles outbreak in the US highlights the need for physicians to be familiar with the deadly disease, particularly in return travelers with fever and rash. The author emphasizes the importance of measles vaccination and vigilance in healthcare facilities to prevent further spread.
The American College of Physicians advocates for a patient- and family-centered approach to physician training, recognizing the value of partnerships between healthcare professionals and their loved ones. The organization's proposal includes establishing guidelines for active participation of patients and families in medical care.
A new delirium severity score helps predict hospital outcomes in patients with delirium. The Confusion Assessment Method (CAM) scoring system is validated for predicting adverse outcomes, including prolonged hospital stay and functional decline. Additionally, a US survey shows that obesity contributes to the dramatic increase in diabet...
The American College of Physicians recommends nine strategies to address societal barriers to reducing firearms-related violence. ACP advocates for approach firearm safety as a public health issue and supports universal criminal background checks to keep guns out of the hands of felons and others at risk.
A systematic evidence review found daily low-dose aspirin can prevent preeclampsia complications by 24% and preterm birth by 14%, with no identified harms. A new approach to breast cancer research suggests reevaluating mammography screening and focusing on prevention through lifestyle changes.
A study published in Annals of Internal Medicine found that men with HIV have a greater risk and extent of coronary artery disease compared to uninfected men. Meanwhile, nearly one-third of patients fail to fill their first-time prescriptions, which may impact clinical outcomes.
The US Preventive Services Task Force found insufficient evidence to recommend routine screening for cognitive decline in older adults. The FDA is reforming its approval process for high-risk medical devices to prioritize patient safety, requiring clinical data and clear labeling.
Researchers found that high consumption of polyunsaturated fats does not reduce coronary risk, while patients with HIV and HCV are more likely to suffer liver decompensation despite treatment. Pneumonia coding practices may also skew hospital performance outcomes due to variations in diagnosis codes.
The USPSTF published its final recommendation statement on primary care interventions to prevent or reduce illicit drug and nonmedical pharmaceutical use in children and adolescents. Nearly one in 10 American adolescents use illegal drugs, with serious health consequences.
A study of high-achieving young physician-researchers reveals pronounced gender differences in domestic activities among those married with children. Additionally, single-patient trials may help determine statin tolerability, while a US survey reports 2.7 million living with chronic Hep C virus.
The USPSTF advises against using beta-carotene, vitamin E, or multivitamins to prevent cardiovascular disease and cancer. However, a balanced diet rich in fruits, vegetables, whole grains, and lean protein sources can provide essential nutrients.
Aortic valve replacement improves symptoms but may not improve overall quality of life for high-risk patients. Researchers found rituximab to be ineffective in treating primary Sjögren's syndrome, while microsporidiosis should be considered in febrile transplant patients, especially those with unexplained illnesses.
Researchers suggest lower-intensity statin combination therapy as an alternative to high-intensity monotherapy for certain patients. Meanwhile, a medical author argues that personal genome services lack evidence to support their claims and may overwhelm the healthcare system.
The American College of Physicians and the Centers for Disease Control and Prevention have released an updated adult immunization schedule for 2014. Key changes include the removal of health care worker vaccination as an indication and updated recommendations for certain adults at increased risk for Haemophilus influenza type b (Hib) i...
The American College of Physicians has published new research on MERS, highlighting the need for better understanding and collaboration to combat its potential as a major public health threat. Guidelines for cholesterol treatment have also been released, sparking debate among physicians, while expert advice is offered on effective scre...
A systematic review and meta-analysis found that access to firearms significantly increases the odds of being a victim of suicide or homicide. The researchers also found that uninsured patients are less likely to be transferred between hospitals for certain medical diagnoses, with women being 35-40% less likely to be transferred than men.
Panel members of the Institute of Medicine's Eighth Joint National Committee opposed relaxing systolic blood pressure targets to 150 mmHg, citing insufficient evidence. The decision may reduce antihypertensive treatment intensity, potentially reversing declines in cardiovascular disease mortality rates.
A Mediterranean diet rich in extra-virgin olive oil reduces the risk of type 2 diabetes by up to 50% without calorie restriction, exercise, or weight loss. The study published in Annals of Internal Medicine suggests that a Mediterranean diet may have public health implications for diabetes prevention.
The US Preventive Services Task Force recommends annual low-dose computed tomography (LDCT) screening for high-risk adults between 55 and 80 years old. Heavy smokers or former heavy smokers who have quit within the past 15 years are considered high risk due to increased lung cancer risk. The recommendation is based on comprehensive evi...
The article discusses the use of unlicensed vaccine Bexsero to combat meningitis outbreaks in the US, as well as new guidelines for BRCA mutation screening in high-risk women. The American College of Physicians also explains how Medicaid expansion will benefit poor citizens and their physicians by increasing access to healthcare.
Most multivitamin supplements have no benefit in preventing chronic disease or death, and long-term use does not preserve cognitive function. Researchers found that high doses of multivitamins and minerals do not protect against cardiovascular events following myocardial infarction.
The American College of Physicians recommends clinical and administrative changes to deter prescription drug abuse while maintaining patient access to treatment. The guidelines advocate for physician, patient, and public education on the harms of medical and nonmedical use of prescription drugs.