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.
Researchers found that aspirin does not reduce costs and increase life expectancy for colorectal cancer prevention. Regular screening tests remain highly effective and cost-effective, even for patients taking aspirin for other reasons.
Two reports on HBV infection shed light on the effectiveness of vaccination programs in reducing the disease rate and carrier state. A study found that 70% of carriers recovered within ten years after treatment, while a nationwide vaccination program for adults is crucial to prevent further transmission.
The ACP-ASIM survey found that 60% of respondents under 40 use handheld computers to access drug information and clinical references. The organization is expanding its educational resources through a Personal Digital Assistant Portal on its website.
A study of internists found that physicians often do not follow best practices due to concerns about patient individuality. The study suggests that noncompliance with guidelines can be a valid reflection of questions about their usefulness and applicability.
A study of 2,437 HIV-infected adults found that patients with case managers had fewer unmet needs and higher use of HIV medications. Screening for hereditary colorectal cancer has been shown to work and may be cost-effective, particularly for relatives of affected individuals.
Local experts urge a $300 million increase in Ryan White/CARE Act funding to ensure stable medical care and treatment for newly diagnosed patients. HIV infection can be managed as a chronic disease with access to services and new anti-AIDS drugs.
Researchers found that women taking hormone replacement therapy were 40% more likely to require gallbladder surgery than those on placebo. Additionally, high-dose cyclophosphamide was successful in treating some aplastic anemia patients, offering potential implications for the treatment of severe autoimmune diseases.
The American College of Physicians announces new standards for manuscript submission, emphasizing author disclosure of sponsor involvement. These revised guidelines, developed by the International Committee of Medical Journal Editors, aim to prevent pharmaceutical companies from controlling study data and results.
A study published in Annals of Internal Medicine found that African-American patients receive fewer heart procedures than white patients, despite having a higher risk of heart disease. Researchers suggest various factors, including patient education and physician attitudes, may contribute to these disparities.
The American College of Physicians-American Society of Internal Medicine has released a comprehensive guide for primary care doctors on obesity diagnosis and management. Obesity rates increased by 30% between 1980 and 1994, carrying significant direct health care costs for the United States. The guide addresses key aspects of medical a...
A study found raw (uncooked), contaminated alfalfa and clover sprouts cause illnesses in California, leading to six outbreaks of salmonellosis and E. coli 0157. Researchers also discovered that hormone replacement therapy (HRT) may help lower blood pressure in women as they age.
The Annals series examines complementary and alternative medicine (CAM), classifying hundreds of therapies into a new taxonomy. CAM modalities like herbs, acupuncture, and homeopathy are studied, as well as the social context and effectiveness of these practices.
The journal launches a series on complementary and alternative medicine (CAM), classifying over 200 therapies into eight categories. ACP-ASIM opposes the legalization of physician-assisted suicide, citing concerns about inadequate care at end-of-life.
The American College of Physicians-American Society of Internal Medicine opposes physician-assisted suicide, considering it a threat to the patient-physician relationship. Instead, they suggest improving access to hospice care, palliative care, and pain management.
Researchers found that ACE inhibitors slowed kidney disease progression, especially for patients with proteinuria. The medications were beneficial for kidney patients and should be given to most patients with kidney disease.
Postmenopausal women taking hormone replacement therapy for less than one year had a 25% increase in risk for recurrent heart disease, while those taking hormones for two years or longer had decreased risk. UTI patients successfully diagnosed and managed their own care with short-term antibiotics.
A new study found that women younger than 60 had a higher mortality rate after heart attacks than men of the same age, with an almost threefold higher risk for death. Researchers also discovered that inhaled insulin shows promise for treating type 2 diabetes, improving blood sugar control without serious side effects.
Research highlights the benefits of physical activity in reducing heart disease risk in women with diabetes. Regular walking and faster walking paces were associated with even lower risks. Additionally, a study suggests that ursodiol may reduce colon cancer risk for some patients with ulcerative colitis.
A study found that weight loss lowered high-normal blood pressure in overweight adults, but only a small percentage maintained substantial weight loss over three years. Another study discovered that scuba diving increases the risk of brain lesions due to decompression illnesses and heart abnormalities.
New data from the Nurses' Health Study suggests hormone replacement therapy reduces heart attack risk by 40% in postmenopausal women. However, taking higher doses of estrogen or combination therapy with progestin may increase stroke risk by 30%.
A cost-effectiveness study finds radiofrequency ablation effective in treating supraventricular tachycardia, improving quality of life and reducing hospital visits. However, the online availability of hydrazine sulfate, touted as a cancer treatment with few side effects, has raised safety concerns after a fatal case report.
Healthcare personnel working in poorly ventilated general hospital rooms were at risk for sero-conversion of tuberculosis. Improving ventilation to at least two air exchanges per hour can help prevent this risk. Additionally, a program using an educational videotape and brochure increased colon cancer screening rates among patients.
A controlled trial of a warfarin therapy control program demonstrated its effectiveness in reducing major bleeding and maintaining acceptable blood clotting levels in elderly patients. The study also found that immediate treatment for mild chronic hepatitis C virus (HCV) would increase survival and reduce costs.
A study by researchers compared colonoscopy to fecal occult blood tests (FOBT) and sigmoidoscopy in screening for colorectal cancer. The findings show that colonoscopy is the most cost-effective option, reducing death rates at relatively low costs by removing precancerous polyps and detecting cancer at early stages.
A study of 3,299 US oncologists found that 22% supported physician-assisted suicide for terminally ill patients with unremitting pain, while 6.5% supported euthanasia. Hydrochlorothiazide was shown to preserve bone density at the hip and spine in healthy older adults.
A randomized trial found that zinc acetate lozenges reduced the duration and symptoms of colds, but caution is needed due to potential copper deficiency risks. Antiretroviral therapy also showed promising results in reducing HIV transmission in semen, but with concerns about drug resistance.
The new book, edited by Howard Libman and Harvey J. Makadon, offers high-quality primary medical care to HIV-infected patients. With contributions from 23 AIDS experts, the book covers pathogenesis, antiretroviral therapy, and infection control.
A study found that prescribing sterile needles is ethical and clinically appropriate for injection drug users. Smoking daily can lead to impaired fasting glucose and type 2 diabetes. Long-term use of drugs promoting gastroesophageal reflux also increases the risk of esophageal adenocarcinoma.
A prospective study of adults with type 2 diabetes found non-traditional risk factors for heart disease, including albumin and fibrinogen levels. Women internists in Pennsylvania earned 14% less per hour than male counterparts. Low body weight was linked to increased fracture risk in women.
The overuse of antibiotics reflects both clinical need and non-clinical factors, including drug companies' advertising campaigns, 'drug hunger,' and a medical system prioritizing productivity. This misuse leads to the development of antibiotic-resistant microbes, posing a significant global threat.
A randomized controlled trial found that a new anti-inflammatory drug decreased kidney function at the same rate as an older medication. Prompt treatment with three powerful antiretroviral drugs after HIV exposure prevented infection in a young girl, according to researchers.
A new study using a decision analysis model found that sildenafil was as cost-effective as kidney dialysis, cholesterol lowering medication or coronary artery bypass surgery. An editorial questions whether health insurance should cover treatment for erectile dysfunction when many Americans are not covered.
Researchers found that long-term anticoagulant use doesn't reduce venous thromboembolism or death after knee or hip surgery. A new study shows promise in treating scleroderma with recombinant human relaxin, reducing skin thickening and improving mobility.
Two studies in Annals of Internal Medicine explore cost-effectiveness of statins on specific populations. Statin therapy was found to be reasonably cost-effective for patients aged 75-84 years old with a history of heart attack, increasing life expectancy by four months while costing $18,800 per quality-adjusted life year. Cost-effecti...
The American College of Physicians-American Society of Internal Medicine has released new guidelines for treating depression with antidepressant drugs. The guidelines highlight the effectiveness of both older and newer medications, as well as the potential risks associated with St. John's wort. Patients should consult their doctor to d...
New antidepressant guidelines suggest both older and newer medications are effective in treating depression. A population-based study found that overweight women are less likely to receive screening for cervical and breast cancer, despite higher mortality rates from these cancers.
A prospective cohort study found that regular exercise can benefit men with type 2 diabetes, while low physical fitness is associated with mortality. Meanwhile, a dangerous combination of blood thinners and intravenous steroids requires daily monitoring to prevent life-threatening bleeding.
A study of 840 men found 32.3% suffered from urinary incontinence, affecting social relationships and physical activity. Whole walnuts were shown to further reduce bad cholesterol in a dietary study. Medical ethicists recommend including spiritual care in treatment plans.
A distinguished panel of bioethicists published papers on physician-assisted suicide in Annals of Internal Medicine, discussing guidelines, safeguards, and expert opinions on the clinical, moral, and ethical issues involved. The findings highlight the need for thoughtful direction and common ground among diverse views.
A consensus panel convened by the University of Pennsylvania's Center for Bioethics discusses guidelines, treatments, and legal responses to assisted suicide. The panel aims to establish safeguards that make physician-assisted suicide voluntary, regulated, and an option of last resort.
A study found that 24% of elderly individuals experienced recurring dizziness, with factors like anxiety, depression, and taking five or more medications contributing to the issue. Two last-resort options for end-of-life suffering are discussed: terminal sedation and voluntary refusal of food and fluids.
A new study finds that subclinical hypothyroidism, a condition prevalent in older women with no observable symptoms, is a strong indicator of risk for hardening of the arteries and heart attacks. Additionally, low-birthweight babies and babies of underweight mothers have a high risk for a diabetic condition.
This issue of Annals of Internal Medicine offers guidance on identifying and treating depression in terminally ill patients. A new program combining physical therapy and exercise is shown to effectively manage osteoarthritis symptoms, potentially delaying surgery for affected adults. Meanwhile, a pet parrot infection has been transmitt...
The ACP-ASIM End-of-Life Care Consensus Panel provides guidance on identifying and managing depression in dying patients, which can improve their quality of life. The panel's recommendations are based on state-of-the-art psychosocial interventions and/or drug treatments.