A large cohort study found that long-term low-dose hydroxychloroquine use is associated with a low risk of developing retinopathy, while higher doses increase the risk. Regular screening can identify the issue at an early stage.
The American College of Physicians summarizes new guidelines for treating patients with diabetes and chronic kidney disease. The 2022 update provides important clarifications to the 2020 guidelines, focusing on comprehensive care, glycemic monitoring, lifestyle interventions, antihyperglycemic therapies, and educational approaches.
The American College of Physicians recommends bisphosphonates as initial pharmacologic treatment to reduce fracture risk in osteoporosis patients. Long-term use may increase risks, so treatment duration should be limited to 5 years or less.
A cost-effectiveness analysis of direct oral anticoagulants (DOACs) versus low-molecular-weight heparin (LMWH) for cancer-associated thrombosis found that DOACs are more medically effective and cost-effective. The most cost-effective DOAC, apixaban, was also shown to be the least costly anticoagulant.
A randomized controlled trial found that a low-carbohydrate, high-fat diet helped patients with type 2 diabetes achieve better weight loss and glucose control over a 6-month intervention compared to a high-carb, low-fat diet. However, changes were not sustained 3 months after the intervention.
A study of over one million Medicaid beneficiaries found that more than half experienced significant lapses in coverage, with only 25% continuously enrolled throughout the period. The authors recommend increasing investments to improve long-term health outcomes.
A study of over 1,000 healthcare workers found that medical masks may be as effective as N95 respirators in preventing COVID-19 infection. However, the results varied across countries and were influenced by factors such as vaccine use and variant circulating during the pandemic.
The American College of Physicians recommends policies to improve healthcare access and quality for incarcerated patients, including adequate funding and timely access to necessary services. The organization also supports treating substance use disorders as an alternative to incarceration.
A randomized controlled trial found that both total ankle replacement and ankle fusion improve quality of life and have similar clinical scores in patients with end-stage ankle osteoarthritis. However, TAR is associated with greater wound-healing complications and nerve injuries, while AF is linked to more blood clots and nonunion of t...
A randomized controlled trial found that oral ENT-01 significantly improves constipation and possibly neurological symptoms in persons with Parkinson disease. The treatment is safe for up to 25 days, with a dose-dependent effect that persists beyond the treatment period.
A large contact tracing investigation found no secondary cases of monkeypox, informing estimates of exposure risk and postexposure prophylaxis recommendations. The framework's ease of application and cross-setting use has important applications for future infection prevention efforts.
The American College of Physicians (ACP) releases a position paper emphasizing the need for policy actions to address climate change, reduce hazardous substance exposure, and promote environmental justice. ACP calls for immediate action to limit global temperature rise and comprehensive efforts to achieve environmental justice.
A study found that 16.5% of American adults with diabetes ration their insulin, with younger adults and the uninsured being most affected. Insulin rationing is often linked to cost concerns, with many patients delaying purchases or taking less insulin than needed.
The American College of Physicians recommends increasing funding for health services and prioritizing health promotion in Indigenous communities. Community-driven public policy is also necessary to address historical trauma, social determinants of health, and inadequate access to healthcare services.
A cross-sectional study of over 70,000 Asian Americans found significant variation in obesity prevalence among subgroups, with Filipino Americans having the highest rate at 28.7% and Chinese Americans the lowest at 13.2%. The study highlights the need for tailored strategies to address obesity disparities among Asian American populations.
A cohort study found that endoscopists performing colonoscopies in FIT-based screening programs should aim for markedly higher ADRs compared to primary colonoscopy screening. The study suggests that high ADRs are associated with lower colorectal cancer incidence and mortality. Researchers recommend using ADR targets, including differen...
A randomized trial found that a 12-week online yoga program improved knee function in participants, but did not significantly reduce knee pain during walking. The study suggests that unsupervised online yoga programs can be feasible and improve physical function, but more research is needed to sustain the effectiveness.
A cross-sectional study of over 25,000 adults found that approximately 70% of identified adrenal tumors were nonfunctioning, regardless of participant's age. The prevalence of adrenal tumors increased with age, from 0.2% in young adults to 3.2% in older adults.
Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is associated with improved birth outcomes, including lower infant mortality. The review also found that WIC participants are more likely to receive child preventative services, such as vaccines.
A prospective cohort study found that drinking two or more cups of black tea per day is associated with a moderately lower mortality risk. The findings suggest that tea can be part of a healthy diet.
A large cross-sectional study found that baseline plasma antigen levels are highly associated with both the severity of pulmonary illness and clinically important patient outcomes in hospitalized COVID-19 patients. Higher antigen levels were linked to increased risk of pulmonary worsening and delayed hospital discharge.
A case-control study found that pregnant women with higher folate levels are at a lower risk of having children with congenital heart disease. The researchers measured red blood cell folate levels and found that those with CHD had significantly lower median levels than those without CHD.
Researchers report two cases of successful treatment with oral tecovirimat for patients with monkeypox and severe proctitis. The medication rapidly alleviated rectal pain with no serious adverse effects. Early use of tecovirimat may be a promising treatment option until randomized controlled trials can be conducted.
Researchers discovered 13 cases of asymptomatic MSM with positive monkeypox virus PCR results in anal samples, raising concerns about the outbreak's transmission dynamics. The findings suggest that vaccination may not be an effective strategy for preventing infection, highlighting the need for expanded public health interventions.
The AABB has released clinical practice guidelines for the appropriate use of COVID-19 convalescent plasma, recommending its use for nonhospitalized patients at high risk for disease progression. The guidelines suggest that CCP is most effective when transfused with high neutralizing titers early after symptom onset.
A cohort study found that reinfection rates are low after successful hepatitis C virus (HCV) treatment in people who inject drugs, suggesting a benefit of treatment in this population. The risk for reinfection was highest among those with ongoing injecting drug use and needle sharing.
The Women's Preventive Services Initiative issues guidelines for preventing obesity in midlife women, recommending counseling on healthy eating and physical activity. The guideline aims to mitigate concerns about weight stigma by normalizing counseling among all midlife women, regardless of BMI status.
The American College of Physicians (ACP) has issued a position paper on the ethical use of genetic testing and precision medicine in internal medicine. The guidelines address key issues such as incidental findings, education for physicians and patients, and counseling needs. ACP emphasizes the need for ongoing surveillance and anticoag...
A secondary analysis of the CARDIA Lung study found that a substantial proportion of middle-aged adults with normal spirometry findings had emphysema on CT scan. Race-specific interpretations of spirometry may underestimate respiratory symptom burden and risk for death in Black adults, perpetuating structural racial inequities.
A longitudinal cohort study found significant reductions in liver disease and mortality among people with HCV infection who received treatment. The study's findings suggest that continued testing, treatment, and community-based interventions could lead to the elimination of HCV infection within the next decade.
A cross-sectional study found significant differences between estimated glomerular filtration rate (eGFR) and directly measured GFR (mGFR), highlighting the importance of considering uncertainty in eGFR calculations. Researchers suggest renaming eGFR as a population average GFR to improve accuracy.
The American College of Physicians (ACP) says inadequate access to nutritious food negatively impacts the health of many Americans, exacerbating social factors and leading to various health issues. The ACP recommends strengthening the nation's food insecurity response and empowering physicians to address social drivers of health.
A study published in Annals of Internal Medicine found that Medicare could save up to $3.6 billion by purchasing generic drugs at the same prices as the Mark Cuban Cost Plus Drug Company. The researchers compared the price of 89 generic drugs sold by MCCPDC to the price Medicare paid in 2020 and estimated potential savings of up to $3....
A randomized controlled trial found that spinal anesthesia was associated with worse pain immediately after surgery, but differences diminished over time. Researchers also found higher rates of pain reliever prescriptions at 60 days in the spinal anesthesia group.
Healthcare workers must be vigilant in detecting and managing suspected monkeypox cases while avoiding stigmatization of affected communities. The authors stress the importance of careful infection control practices and community allyship with men who have sex with men to combat the outbreak.
A review of 25 trials found that synthetic cannabis products with high THC-to-CBD ratios improved chronic pain, but were associated with higher risks of adverse events. In contrast, products with comparable THC-to-CBD ratios showed few benefits in overall functioning.
A secondary analysis of the MOVe-OUT trial found molnupiravir-treated participants had a decreased need for respiratory interventions and fewer COVID-19-related acute care visits. Additionally, they showed faster normalization of biomarkers and were discharged earlier than placebo-treated patients.
A cohort study found that moderate coffee consumption, especially unsweetened coffee, is associated with a lower risk of death. The results suggest that adults who drink 1.5 to 3.5 cups of coffee per day may be less likely to die during a 7-year follow-up period compared to non-coffee drinkers.
The current monkeypox outbreak is more widespread than previous ones outside of Africa, with significant cases reported in Europe, the UK, and North America. A notable increase in cases among men who have sex with men has been observed, although the cause remains unclear.
A review of 38 randomized controlled trials found that counseling patients about contraceptive use and providing contraceptives increases use without increasing STI risk or reducing condom use. The interventions also decrease unintended pregnancy in trials designed to evaluate this outcome.
A new analysis of nationally representative data reveals a significant increase in the impact of HPV vaccination efforts, leading to decreased prevalence of cancer-causing HPV infections among both vaccinated and unvaccinated females. The study found that vaccination has directly protected individuals and generated herd effects, reduci...
A new study suggests that tailoring diabetes screening for Black, Hispanic, and Asian Americans based on lower BMI thresholds and younger ages can significantly reduce disparities in diabetes diagnosis rates. This approach may improve health equity by identifying cases earlier and reducing mortality rates associated with diabetes.
State bans on affirmative action policies are associated with lower enrollment of underrepresented minority students in public medical schools. The study found a 5.5 percentage point decrease in enrollment of underrepresented students relative to control schools.
A new study validates the Canadian Syncope Risk Score as a reliable tool to identify patients at low risk for serious outcomes after 30 days, potentially reducing hospitalization rates. The score showed better performance than another validated score, but its clinical utility remains uncertain and warrants further research.
A systematic review and meta-analysis found that SGLT2 inhibitors reduce hospitalizations and cardiovascular deaths in heart failure patients, regardless of diabetes status. The analysis also warned of increased genital infections associated with treatment.
A California study found that adults living with handgun owners had twice the homicide rates compared to those without, with most victims being women. Survivors of nonfatal gunshot injuries also experienced significant healthcare costs and worsening mental health.
A large cohort study found that babies born to men who took metformin during sperm development were at increased risk for genital defects in boys. Diabetes control affects sperm quality, so men should discuss alternative treatments with their doctors before conception. The findings suggest a need for further study on treatment of prosp...
A retrospective cohort study found that shoulder injuries occurred in fewer than 1 in 10,000 patients who received intramuscular vaccinations administered in the deltoid muscle. Researchers also identified risk factors for developing shoulder conditions, including advanced age, female sex, and receiving pneumococcal conjugate vaccine.
A study of insurance claims data found that state laws governing opioid prescribing had a negligible effect on opioid prescribing trends. The authors suggest that shifting clinical guidelines, professional norms, or other factors may be driving the decline in opioid prescribing. In contrast, a post-hoc analysis of an ASPREE trial found...
A retrospective analysis found that socioeconomically disadvantaged older adults are at a higher risk of decline in function and cognition after an intensive care unit hospitalization. The study highlights the need to prioritize low-income seniors in rehabilitation and recovery efforts after critical illness.