The American College of Physicians recommends aiming for blood pressure levels less than 135/80 mm Hg in patients with type 2 diabetes. Thiazide diuretics and ACE inhibitors can be used as first-line agents to control blood pressure, but patients may need multiple medications.
Research shows a decrease in antibiotic prescriptions in the US, but an increase in broad-spectrum antibiotic use, which can lead to antibiotic resistance. This shift poses significant global public health concerns, particularly for treating infections like HIV, tuberculosis, and malaria.
A high-meat protein diet may accelerate loss of kidney function in women with mild chronic kidney disease, according to data from the Nurses Health Study. Meanwhile, implantable cardioverter defibrillators have been shown to significantly reduce sudden cardiac death and deaths from all causes in many patients.
A daily multivitamin and mineral supplement reduced the incidence of minor infections among healthy people over 45. Intentional weight loss was associated with a 24% lower death rate compared to unintentional weight loss.
A new study found that patients in higher-spending regions receive more care, but it does not translate to better outcomes, patient satisfaction, or access to care. Removing liver tumors by ethanol injection therapy followed by interferon therapy may reduce the risk of tumor recurrence in patients with chronic hepatitis C virus.
A comprehensive analysis found that Medicare enrollees in higher-spending regions don't have better access to or quality of care, nor do they have better survival rates. In fact, those in higher-spending regions were less likely to receive preventive services.
A study examining ephedra's effects found it was more likely to cause negative side effects than other herbs; sale of ephedra as a supplement should be restricted or banned due to increased risk. A hospital discharge period is also deemed dangerous for patients, with one in five experiencing adverse events after going home.
The study found a significant discrepancy between recommended adjuvant chemotherapy and actual use, with younger women more likely to receive treatment. Overall, only 29% of women received chemotherapy, highlighting the need for re-evaluation of current NIH guidelines.
Smallpox experts suggest limiting vaccinations to first responders to prevent complications and ensure public safety. The authors cite studies from the 1960s documenting vaccine-related complications, including spread to close contacts and increased risk of morbidity and mortality.
A study on breast cancer treatment found that many women do not receive adjuvant chemotherapy as recommended, with age being a significant factor. In contrast, women with known heart disease are at high risk of future heart events but often lack preventive treatments, highlighting the need for better care coordination.
A study of over 3,357 people found that excess weight can cut years off a person's life, with smokers losing up to seven years. Meanwhile, hormone therapy was shown to lower the risk of diabetes in postmenopausal women by 35%.
A study analyzing Boston smallpox case records found that young patients, those unvaccinated, and those with severe disease had the lowest survival rates. In contrast, a college student study on echinacea found no effect on cold symptoms, highlighting the need for more research into its efficacy.
Recent studies have found that hospitalists provide better patient outcomes in terms of reduced costs, shorter hospital stays, and lower short-term mortality rates compared to non-hospitalist physicians. The benefits of hospitalist care became evident only after the second year of both studies, highlighting the importance of experience...
A new study supports routine mammography screening for women over 75, while a separate study finds that postmenopausal hormone use and heavy drinking increase breast cancer risk. The guidelines also recommend against combined estrogen and progestin therapy for preventing cardiovascular disease in postmenopausal women.
The American College of Physicians and the American Academy of Family Physicians have released new guidelines for treating migraines, recommending immediate treatment with NSAIDs or triptans, as well as managing nausea and vomiting symptoms. The guidelines also emphasize the importance of patient involvement in charting migraines and i...
A study of 75 patients found that postponing care for those with non-serious illnesses had comparable health outcomes to immediate care. Additionally, a new combination therapy for arthritis patients showed promise in reducing joint symptoms and improving function.
The American College of Physicians' Task Force concludes that combined estrogen and progestin therapy has more likely to cause harm than benefit for most women. The evidence is insufficient to recommend hormone therapy alone or together for preventing chronic conditions in postmenopausal women with hysterectomies.
Methadone treatment is being expanded to office-based practices for patients with addiction, aiming to make it more accessible. Hair analysis has been found to be a significant advance in assessing exposure to antiretroviral therapies and monitoring patient response to indinavir, an anti-HIV drug.
Two studies found that patients with kidney disease are at increased risk of death after a heart attack, receiving less-aggressive treatment. Meanwhile, researchers report four cases of muscle damage caused by statins, highlighting the need for closer monitoring.
The USPSTF recommends that physicians routinely screen women over 65 for osteoporosis, a thinning of the bones that can lead to bone fracture. Women at higher than average risk should begin screening at age 60. Early nephrologist care is associated with better outcomes for kidney disease patients, particularly those with African-Americ...
A Canadian National Breast Cancer Screening Study found that annual mammography for five years had no impact on breast cancer deaths in women aged 40-49. The US Preventive Services Task Force recommends starting mammography at age 40, but evidence is considered 'fair' due to conflicting results.
A new study found that flu vaccines can benefit healthy working adults aged 18-50 by avoiding lost work time and treatment costs. Hormone replacement therapy does not prevent or reduce the rate of developing heart disease, contrary to earlier studies.
The ACP Annals Tip Sheet discusses growth hormone deficiency treatment, exercise counseling effectiveness, and West Nile virus prevention strategies. The USPSTF found mixed evidence on exercise counseling's impact on patient activity, while recommending public mosquito control programs for virus prevention.
The US Preventive Services Task Force recommends that all adults over 50 be screened for colorectal cancer using methods like the fecal occult blood test or flexible sigmoidoscopy. The Task Force also notes that clot-busting drugs and angioplasty are underused in certain patient groups, particularly women and specific types of heart at...
The American College of Physicians recommends screening adults over 50 for colorectal cancer. The Task Force identified two screening methods that have been shown to reduce death from colorectal cancer: the fecal occult blood test and flexible sigmoidoscopy.
The ACP-ASIM published 'Osteoporosis' guide provides the latest scientific evidence on osteoporosis and essential information on its origins and progress. It addresses every facet of osteoporosis, a common disease that can be identified through non-invasive tests and treated with new effective drugs to reduce fractures.
The US Preventive Services Task Force (USPSTF) advises women at low risk for breast cancer to avoid taking drugs like tamoxifen or raloxifene. Women at high risk, however, should have open discussions with their doctors about the benefits and risks of these medications.
Celebrating its 75th anniversary, Annals of Internal Medicine has published influential articles on Lyme disease, HIV/AIDS, and evidence-based medicine. The journal has continued to evolve with innovative features like structured abstracts and international discussions on editorial issues.
A study found contaminated E. coli bacteria in hot sauces from popular tourist restaurants in Mexico and Texas, increasing the risk of travelers' diarrhea. A simple test can detect peripheral arterial disease by comparing blood pressure in the arm and lower leg.
A US study found that 26% of men and 28% of women were obese by age 35-37, with black women and Hispanic men at higher risk. Obesity is linked to various health problems, including heart disease, diabetes, and stroke.
A new series of articles explores the causes of medical errors, highlighting the limitations of relying solely on patient charts. Increasing the number of reviewers and requiring confidence in negligence can reduce rates of negligent events.
The US Preventive Services Task Force recommends screening all adults for depression, according to new guidelines. A Canadian study also found that men and women receive equal treatment for coronary heart disease once their condition is known, challenging previous reports of bias.
The USPSTF recommends screening all adults for depression, as five percent to nine percent of adult patients in primary care settings suffer from the condition. Depression can be treated with counseling, medications, or both, reducing health care utilization and costs associated with lost workdays.
Only 60.5% of US adults are fully protected against diphtheria and 72.3% against tetanus, with disparities among age groups and ethnicities. Reorganizing physician practices to prioritize preventive services can increase immunization rates.
Two new studies published in Annals of Internal Medicine shed light on diabetes diagnosis and management. A mathematical model predicts type 2 diabetes with high accuracy, while a report card reveals significant gaps in diabetes care. Additionally, experts emphasize the importance of preventive methods to address partner violence.
A study of 643 women found that C-reactive protein (CRP) levels are an indicator of increased cardiovascular risk in people with no signs of heart disease. Regular exercise has been shown to decrease blood pressure in all groups of people, regardless of their weight or ethnicity.
A study of 118 people with early Lyme disease found most had a red rash with central redness, not the traditional bull's-eye description. The patients' liver function returned to normal after treatment with antibiotics. Meanwhile, a case report describes pioglitazone causing liver damage in a diabetic patient.
The American College of Physicians has updated its guidelines to ensure physicians maintain independence in patient care. The new advice urges individual physicians to avoid industry relationships that may compromise objectivity.
Acupuncture has been shown to be effective in treating vomiting after chemotherapy or surgery, as well as nausea associated with pregnancy. However, its effectiveness in treating chronic pain, back pain, and headache is still a topic of debate, with conflicting results from clinical trials.
A study of 115 residents found that 76% suffered from burnout, with half being depressed and nine percent misusing alcohol. Residents with heavy education-related debts were more likely to moonlight and experience depression.
The incidence of second primary colorectal cancer is high despite regular surveillance colonoscopy after treatment of the initial cancer. Many second cancers were diagnosed within one year after a normal colonoscopy, indicating the need for further research to determine the best schedule for surveying the colon.
A large study of men's health habits found that a prudent diet significantly reduces the risk of developing type 2 diabetes. The study indicates that avoiding weight gain and eating a balanced diet may substantially reduce this risk, highlighting the importance of a healthy lifestyle in preventing the disease.
Three influential organizations of internal medicine physicians unveil a new charter on medical professionalism, outlining three fundamental principles and ten definitive professional responsibilities. The charter aims to promote an action agenda for the profession, addressing challenges in healthcare delivery, technology, and globaliz...
A study in Annals of Internal Medicine finds that accurate profiling of physician care depends on study design, and that most quality initiatives fail to adjust for patient characteristics. Additionally, researchers estimate that colonoscopy is a cost-effective strategy for investigating rectal bleeding in young people
The USPSTF recommends discussing aspirin therapy with adult patients at increased risk of coronary heart disease, such as those with unfavorable cholesterol levels, smoking, or hypertension. Aspirin may help prevent heart attacks in these individuals, but its benefits and harms should be carefully weighed.
Six popular herbal therapies - Ginkgo, St John's wort, Ginseng, Echinacea, Saw palmetto, and Kava - have varying levels of effectiveness and safety. Prednisone, a glucocorticoid, reduced swelling and progression of damage to joints in patients with early active rheumatoid arthritis.
A recent study revealed that screening high-risk patients for diabetes may not be cost-effective, with a low yield and high cost. Additionally, a quality intervention to improve depression care was ineffective in real-world settings, highlighting the need for system changes to close care gaps.
The article highlights three articles addressing hypertension control: managing diabetes, blood pressure-lowering drugs, and the DASH diet. Additionally, a study reveals gaps in newspaper articles on mammography, which often oversimplify or misrepresent scientific evidence.
Two studies examine the link between sex hormones and coronary artery spasm, finding that estrogen levels during menstruation affect blood vessel function. Automated external defibrillators are also shown to be safe and easy to use by trained laypersons, paving the way for potential home sales.
A new study found that 41% of physicians would perform at least one action proscribed by the AMA's ethics guidelines, while 25% would perform five or more actions. The study suggests that some physicians are morally confused about their role in capital punishment.