A study of female nurses found that a higher body mass index at age 18 was associated with greater risk for death than a normal BMI. Meanwhile, severely obese adolescents who received diet drug sibutramine along with behavior therapy lost an average of 14 pounds and improved heart risk factors.
A study found that acupuncture improved knee pain in patients with osteoarthritis, even when compared to sham acupuncture. Another study revealed that Mediterranean diets improved blood pressure, cholesterol levels, and blood sugar levels in older adults at risk for heart disease.
A randomized trial found abatacept to be effective in reducing disease activity and slowing joint damage in patients with active chronic rheumatoid arthritis. However, the treatment also led to a higher incidence of serious infections and infusion reactions compared to placebo. Meanwhile, hospital care for patients with COPD varies wid...
A meta-analysis of 33,826 asthma patients found that long-acting beta-agonists increase hospitalization rates by 2.5 times and life-threatening asthma attacks by two times compared to placebo. Naps and caffeine can combat fatigue in medical interns and night drivers.
A new study offers a simpler approach to diagnosing urinary incontinence in women by asking patients three simple questions. Meanwhile, an update to the US hepatitis C profile reveals that infected individuals are entering their 40s and 50s, increasing the risk of disease consequences such as cirrhosis and liver cancer.
A study of 80 moderately obese patients found that laparoscopic gastric banding led to a significant average weight loss of 21.6 percent, compared to 5.5 percent in the nonsurgical group. Lifestyle modification can also achieve up to 10 percent weight loss.
The American College of Physicians emphasizes the need for a comprehensive healthcare response to pandemic influenza, highlighting the critical role of primary care physicians. The organization recommends hands-on clinical training for internists to address public health crises like pandemic influenza.
A recent study found that diabetes care has improved over the past decade, but two in five people with diabetes still have poor control of cholesterol and blood pressure. Lifestyle changes can significantly reduce the risk of heart disease for those with mild hypertension.
The second edition of 'Medicine in Quotations' features over 450 new quotations on various topics, fully referenced to their original sources. The book offers a unique perspective on the evolution of medical concepts and practices.
The American College of Physicians (ACP) will release recommendations for reforming primary care compensation, education, and training. The reforms aim to strengthen the importance of primary care in the healthcare system by recognizing its value and role in delivering better quality care at lower costs. ACP leaders will discuss a comp...
A new study of 50,000 people found that heavy smoking leads to a higher risk of premature death, particularly among men and women. The study also highlighted the benefits of quitting smoking early, with those who quit experiencing greater health benefits and longevity.
The article discusses scientific fraud prevention and the growing concern of community-acquired MRSA infections. The key responsibilities for addressing misconduct can be shared among institutions, co-authors, and journal editors.
Researchers found patients with rheumatoid arthritis have a three-fold increase in carotid artery atherosclerosis compared to those without RA. Statins and b-blockers may also affect coronary heart disease severity, while hospital volume doesn't correlate with pneumonia care quality.
A new clinical prediction rule for estimating the probability of PE significantly reduces adverse outcomes by identifying patients at low or high risk. The revised Geneva score provides a standardized, easy-to-compute tool for diagnosing and managing PE.
Researchers report three cases of severe liver failure and hepatitis linked to telithromycin, a newly approved antibiotic. The study highlights the potential risk of idiosyncratic drug reactions at one medical center.
A new study published in Annals of Internal Medicine found that regular exercise reduces the risk of dementia and Alzheimer's disease by 30 to 40 percent. The study, which followed 1,750 adults aged 65 and older for six years, showed that exercising three or more times a week significantly reduced the risk of developing dementia.
A large prospective study found that exercise reduces dementia risk by 30-40% in older adults. The study also highlights the importance of monitoring physician performance and addressing disparities in healthcare outcomes.
59% of general internists, 60% of subspecialists participated to improve professional image and update medical knowledge. The survey also found that 69% of general internists believed board-certified physicians are more competent than non-certified ones.
A survey of internists reveals the most common reasons for recertification are to maintain professional image and update knowledge. In contrast, a review finds no evidence that oral nutritional supplements help elderly patients in a home setting. Meanwhile, unsupervised walking at home can slow decline from peripheral arterial disease.
A study published in Annals of Internal Medicine found that yoga, specifically Viniyoga, significantly improved back function and reduced pain in patients with lower back pain. Regular home practice and supervised instruction were essential for successful treatment.
A study of 2,160 people who had heart attacks found a high risk of stroke in the first month after the heart attacks. Hospital care at home was shown to be feasible and cost-effective, with patients receiving similar quality of care as those hospitalized.
A study of high-risk individuals found that condom use was associated with lower rates of herpes simplex virus-2. Pregnant women were four times more likely to experience blood clots than non-pregnant women, with the risk increasing during the postpartum period. Condoms remain a proven method for reducing STD risks in at-risk individuals.
A study of 11,481 childhood cancer survivors found that 20% had physical performance limitations compared to 12% of their siblings. Rehabilitation programs improved survival rates after heart attacks by reducing subsequent heart attacks by 17%.
The Oct. 18 issue of Annals of Internal Medicine describes two new diabetes treatments: exenatide, an injected drug; and inhaled insulin. Exenatide improved overall sugar control, but patients experienced weight loss and more side effects compared to insulin glargine.
The ACP Expert Guide to Sports Medicine covers assessment and management of common musculoskeletal injuries and other sports-related conditions. The book is organized in three sections: Overview, Medical Conditions (non-musculoskeletal), and Musculoskeletal Injuries, with tables, illustrations, and case studies.
A study of Medicare patients with heart attacks found significantly higher 30-day death rates in December compared to other months, with 22% of those hospitalized in the month dying within 30 days. The study looked for use of proven therapies but authors remain uncertain about the cause of the increased mortality rate.
A survey of 44 medications found that 43 were cheaper in Canada than in the US, with potential savings of up to 24% per dose. Second-generation antidepressants showed similar efficacy and safety compared to other options, making choosing an antidepressant difficult for patients.
The US Preventive Services Task Force recommends routine genetic counseling for women with a family history of breast cancer or Ashkenazi Jewish descent. A new study found that tiotropium, an inhaled bronchodilator, reduces COPD flare-ups and hospitalizations compared to a placebo.
The US Task Force does not recommend routine screening for breast cancer gene mutations in women without a specific family medical history. However, they do suggest screening for women with a history of Ashkenazi Jewish descent, young-onset breast cancer, or multiple relatives with breast and ovarian cancer.
A study of 372 community-dwelling older patients found that those receiving high-quality care had better survival rates than those without it. The research created a quality-of-care score based on 236 process-of-care measures, with survival improving steadily as the score increased.
A new analysis of existing studies reveals that individuals with overweight or obesity are at a higher risk of experiencing GERD symptoms, erosive esophagitis, and esophageal cancer. In contrast, researchers found no significant difference in mortality rates between patients undergoing peritoneal dialysis or hemodialysis for end-stage ...
A national survey reveals that many Americans take high doses of vitamin E supplements, despite potential risks, and a study shows that test results are frequently forgotten after hospital discharge. A new study suggests that full coverage for ACE inhibitors would improve health outcomes and save Medicare money.
The USPSTF has issued new recommendations for HIV screening, which will be posted on the journal's website and the Agency for Health Care Research and Quality's website. The Task Force recommends testing for all individuals at risk of HIV infection, as well as pregnant women to prevent mother-to-child transmission of AIDS.
A new 12-week study of 302 adults with high-normal or mildly elevated blood pressure found that eating special cookies containing 40 grams of soybean protein resulted in significantly larger decreases in pressure levels compared to those who ate similar cookies made of complex wheat carbohydrate. The soybean group had a net reduction o...
Physicians performing independent medical examinations (IMEs) still owe legal duties to patients, even without traditional relationships. The U.S. health care provider market is a key factor in rising health care costs, with strong market power driving high prices and quantity of medical services.
A recent analysis found that U.S. adults could save up to $8.8 billion per year by using generic drugs instead of brand-name drugs. Additionally, a study on Gulf War veterans revealed four more common health conditions among those who served in the conflict compared to non-deployed individuals.
Major medical journals, including Annals of Internal Medicine, will consider publishing results of clinical trials only if they are registered in a publicly accessible database before enrollment begins. The International Committee of Medical Journal Editors (ICMJE) has adopted a set of 20 required data elements for trial registration.
Researchers found rifaximin significantly reduces mild diarrhea in travelers, while updated guidelines advise against hormone replacement therapy (HT) for postmenopausal women after hysterectomy. A study also discovered that slightly elevated blood sugar levels do not increase the risk of new heart attacks in women with established cor...
Exercise therapy has a small beneficial effect on chronic low back pain but no impact on shorter-term pain, according to two new studies. A plant-based low-fat diet is also better at lowering LDL cholesterol levels than a similar diet without veggies.
A new study on anthrax attacks suggests post-attack vaccination plus antibiotic therapy is the most effective strategy. Meanwhile, an analysis of data from a large randomized trial found that both metformin and lifestyle changes can slow metabolic syndrome progression, with lifestyle change providing greater benefits.
The new Ethics Manual revisits and expands on earlier topics, including sections on chaperones and privacy, gifts from patients, and health and human rights. The fifth edition provides an ethical framework for physicians to make complex decisions in a changing environment.
The American College of Physicians recommends a weight loss approach that includes diet and exercise for everyone, with medication or surgery considered only for those who fail to achieve weight loss goals. However, the guidelines also warn about potential side effects and risks associated with surgical procedures.
The American College of Physicians (ACP) recommends a multi-faceted approach to treating obesity, including lifestyle changes, weight-loss drugs, and bariatric surgery. ACP identifies six valid weight-loss drugs, but emphasizes the need for frank discussions about potential side effects and lack of long-term efficacy data.
A new study published in Annals of Internal Medicine found that obese patients with type 2 diabetes who followed a very low-carbohydrate diet lost significant amounts of weight. The participants consumed fewer calories on the low-carb diet, resulting in improved blood sugar levels and reduced triglycerides and cholesterol levels.
A three-week study of ten obese volunteers with mild type 2 diabetes mellitus found that a very low-carbohydrate diet led to an average weight loss of 3.6 pounds, primarily due to reduced calorie intake rather than loss of body fluid or increased metabolism. The results suggest that carbohydrate restriction may stimulate excessive appe...
Two studies examine the prevention of type 2 diabetes mellitus, a condition that affects millions of Americans. Researchers found positive lifestyle changes lowered risk among nonsmokers but not smokers. A computer simulation determined the diet-exercise program and metformin therapy were cost-effective options.
A 14-year study published in Annals of Internal Medicine found that quitting smoking can add years to life. The study showed a significant reduction in death rates among participants who quit compared to those who continued to smoke.
A new study of 5,887 middle-aged smokers found that those who quit smoking had a significantly lower death rate than those who continued to smoke. The annual death rates for quitters were 6.0 per 1000 patients compared to 11.0 in non-quitters, showing a 46% reduction.
The American College of Physicians recommends one-time ultrasound examination for abdominal aortic aneurysm screening in men aged 65-75 who are smokers. New evidence suggests that large abdominal aneurysms may reduce deaths from ruptured aneurysms. Meanwhile, a study found that the COX-2 inhibitor rofecoxib increases heart attack risk ...
Current FOBT screening recommendations are being reexamined due to low test accuracy and non-compliance. A study of 3,121 people found that single office-based FOBT tests missed advanced precancerous lesions 95% of the time.