A longitudinal study found that adherence to the Medicare Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) had variable effects on sepsis treatment and patient outcomes. Researchers suggest that clinicians may have discretion in applying SEP-1 components to focus on aspects of care driving improvements in patient outcomes.
The new online-only journal aims to share valuable lessons from clinicians' discussions on challenging cases, contributing to medical innovation and improved care. The digital, peer-reviewed journal will publish bi-monthly issues initially and become more frequent over time.
Researchers from NIH propose a new method to estimate vaccine efficacy by following original placebo recipients after vaccination, allowing assessment of durability and potential delayed harm. This approach enables timely access to the vaccine for placebo recipients while maintaining unbiased estimates.
A nationally representative survey found that over 40% of US adults aged 50-80 trust online reviews almost as much as family or friend recommendations when selecting a physician. Factors such as insurance acceptance and race/ethnicity were more influential, with online reviews ranking ninth in importance.
The American College of Physicians suggests prescribing shorter antibiotics courses for uncomplicated bronchitis, pneumonia, urinary tract infections, and cellulitis, with duration guidelines varying by infection. This approach aims to reduce antibiotic exposure and prevent resistant organisms from developing.
Case report describes two patients who underwent a successful second dose of the Moderna vaccine using a graded dosing protocol after experiencing immediate hypersensitivity reactions. Both patients responded well and developed IgG antibodies, suggesting effective vaccination despite the modified dosing schedule.
The American College of Physicians suggests that physicians should educate patients about firearm safety, act locally against the NRA, and lobby for sensible firearm injury prevention laws. The editorial highlights the need for action after mass shootings, despite a decline in overall gun violence in 2020.
A study of over 56,000 patients found that new users of direct oral anticoagulants (DOACs) had lower risks for ischemic stroke or systemic embolism and major bleeding events compared to warfarin. DOACs were associated with greater effectiveness and fewer major bleeding events in adults with valvular atrial fibrillation.
New studies published in Annals of Internal Medicine reveal significant disparities in COVID-19 testing, positivity, confirmed cases, and mortality rates across different populations. These findings highlight the need for targeted interventions to address health inequities in the US healthcare system.
A cost-effectiveness analysis found that total knee replacement surgery is a viable option for patients with extreme obesity and end-stage osteoarthritis, offering significant improvements in quality-adjusted life expectancy. The study concluded that TKR leads to substantial benefits in these patients, outweighing potential complications.
A cohort study found that switching from TDF to TAF-containing ART was associated with significant weight increases, obesity, and rising blood lipid levels in people living with HIV. The study suggests individualized preference for TAF over TDF should be accompanied by repeated assessment of cardiometabolic risk factors.
Researchers found that participants with obesity and food insecurity lost less weight than their food-secure counterparts over a 24-month period, despite following an intensive lifestyle-based intervention. The study highlights the need for weight loss approaches that address both obesity and food insecurity.
Researchers tested CER-001 on a human patient with familial LCAT deficiency, showing improved kidney function and stable vision for up to 11 months. The treatment was well-tolerated, but further studies are warranted to prevent kidney progression.
Researchers found amoxicillin-clavulanate as effective as metronidazole-with-fluoroquinolone in preventing diverticulitis-related admissions. The treatment reduced the risk of fluoroquinolone-related harms, including Clostridioides difficile infection.
A Zika virus candidate, Ad26.ZIKV.001, showed promising safety and immunogenicity in a phase I clinical trial. The vaccine induced persistent neutralizing antibody responses and was found to be safe with mild to moderate reactogenicity. Researchers recommend further development of the vaccine should the need reemerge.
The Advisory Committee on Immunization Practices (ACIP) has released its 2021 Recommended Adult Immunization Schedule, which includes interim recommendations for COVID-19 vaccination. The updated schedule features revised content and harmonized changes with the Child and Adolescent Immunization Schedule.
The American College of Physicians (ACP) has updated its practice points on the use of remdesivir in treating hospitalized COVID-19 patients. The new guidelines aim to target patients who are most likely to benefit from treatment, recommending a duration of treatment based on symptom duration and disease severity. According to the upda...
A mammography screening strategy based on a baseline breast density measure at age 40 is the most effective and cost-effective way to reduce breast cancer mortality. The study suggests that this approach can lead to a significant reduction in breast cancer mortality, but also increases the number of mammograms performed and false posit...
A study analyzing Kaiser Permanente members found racial minorities more likely to test positive for COVID-19 than white patients, with Latino patients nearly 4 times as likely. Healthcare workers in Los Angeles expressed hesitancy about getting the COVID-19 vaccine, citing concerns over development and science.
Taiwan's rapid response to COVID-19 has led to a decrease in overall death rates compared to 2019, suggesting mask-wearing and physical distancing had a positive impact. Immunization experts also call on clinicians to utilize immunization information systems to facilitate fair and equitable COVID-19 vaccine distribution.
A recent study published in Annals of Internal Medicine found that community and demographic factors, such as contact with a confirmed or suspected COVID-19-positive case outside the workplace and Black race, were stronger predictors of COVID-19 infection than occupational exposure among healthcare workers. The study also highlights th...
The American College of Physicians and Annals of Internal Medicine hosted a third virtual COVID-19 vaccine forum, discussing the allocation and distribution of available vaccines. Researchers also published an observational study finding that early therapeutic anticoagulation in critically ill patients with COVID-19 did not affect surv...
Close adherence to low-dose aspirin therapy resulted in 8 more pregnancies, 6 fewer pregnancy losses, and 15 more live births per 100 women. Starting aspirin before or early pregnancy showed stronger benefits than starting after the 6th week.
A review of 61 studies confirms that at least 1 in 3 people infected with SARS-CoV-2 do not exhibit symptoms, suggesting widespread testing can help identify asymptomatic spreaders. The findings also underscore the importance of determining vaccine effectiveness against asymptomatic infections.
A recent study found that mortality rates decreased among critically ill COVID-19 patients over time. In contrast, experts from NIAID emphasized the importance of using data to encourage vaccine uptake. Meanwhile, a hospital essay describes a Ransomware attack during the pandemic, highlighting the challenges faced by healthcare profess...
Research suggests that primary care physicians play a smaller role in high-value spending than previously thought, with most PCPs contributing less than 9% of low-value spending per patient. Genetic testing is also limited in predicting disease in healthy individuals, highlighting the need for caution in its use as a preventive tool.
Researchers developed saliva-based testing as a sensitive alternative to nasal swabs. High demand for PPE revealed society's dependence on forced labor during the pandemic. No association was found between COVID-19 mitigation strategies and risk of preterm births or stillbirths. A new case report suggests a potential link between SARS-...
The American College of Physicians (ACP) has released a comprehensive framework to address disparities and discrimination in healthcare, proposing policy recommendations to enhance quality and effectiveness for all patients. The framework also discusses specific contributors to health disparities and steps to improve them.
Researchers suggest that single-dose vaccines may offer greater population benefit due to the speed-versus-efficacy tradeoff. Alternative dose allocation strategies also improve benefits by vaccinating more people sooner while maintaining scheduling for second doses.
Research suggests that state laws requiring flu vaccination for hospital workers can reduce pneumonia and influenza mortality rates, particularly among the elderly. A quasi-experimental study found a 2.5% reduction in monthly pneumonia and influenza mortality rates after law implementation, averting approximately 1,822 deaths.
A review of over 100 research articles concludes that masks worn by lay persons reduce the spread of respiratory viral infections, including SARS-CoV-2. Observational studies suggest universal masking can lead to large reductions in transmission rates, even with imperfect cloth face coverings.
A retrospective cohort study found that testing for primary aldosteronism in patients with treatment-resistant hypertension was rare and associated with higher rates of evidence-based treatment and better blood pressure control. An adaptive stepped exercise program improved pain and physical function in knee osteoarthritis patients.
The American College of Physicians (ACP) hosted a virtual COVID-19 Vaccine Forum II to address barriers to optimal vaccine uptake. Panelists emphasized the need for comprehensive public health communications campaigns to refute misinformation and build trust among disproportionately affected minority communities.
A recent study found that combining mandatory mask-wearing policies with extensive social distancing can prevent most COVID-19 cases on college campuses, with routine testing also showing high effectiveness. However, the cost of testing may be a barrier for some colleges and universities.
A national survey of 4,000 adults found that fewer than 10% have ever discussed firearm safety with a clinician, highlighting the need for improvement in clinical settings. The study also found that when conversations occurred, the most common advice given was to lock all household firearms.
Researchers analyzed SEER 18 data and found adenocarcinomas to be the predominant cancer subtype in screening, surveillance, and prevention. The study also revealed that carcinoid tumors are increasing at a faster rate than adenocarcinomas, but adenocarcinomas are still steadily increasing in most early-onset subgroups.
A study estimates that accounting for recent population aging reduced non-COVID-19 excess deaths in the US by 65%. The number of COVID-19 deaths remained unchanged. These findings can guide clinical and public health interventions to prevent future unnecessary deaths.
A randomized trial found that higher doses of vitamin D3 supplementation did not reduce the risk of falls in older adults with elevated fall risk and low vitamin D levels. In contrast, some analyses suggested that higher doses may increase the risk of serious falls and hospitalization.
Researchers investigate various aspects of COVID-19. A study finds hydroxychloroquine has no benefit in preventing SARS-CoV-2 infection after exposure. Meanwhile, a review reveals patients with COVID-19 can develop prolonged illness, sometimes referred to as 'Long COVID'. Additionally, a Wuhan study sheds light on viral persistence and...
A study published in Annals of Internal Medicine found that nearly 40% of US adults with overweight and 10% with obesity do not consider themselves overweight. This lack of self-awareness is linked to lower attempts to lose weight and contributes to rising obesity rates.
A recent supplement to Annals of Internal Medicine highlights the need to address maternal mortality and morbidity in the US. Research suggests that focusing on prenatal care, addressing inequities and disparities, and improving healthcare access are crucial steps forward.
A systematic review of COVID-19 data in the US reveals disproportionately higher rates of infection and mortality among African American/Black and Hispanic populations. The authors call for urgent interventions to mitigate these disparities. Read the full text to learn more about the findings.
A systematic review found financial payments from the drug industry to US physicians are associated with increased prescribing of the paying drug company's medication. The association was consistent across all studies, suggesting a causal link between industry gifts and physician prescribing practices.
Recent studies published in Annals of Internal Medicine investigate the association between ABO blood groups and SARS-CoV-2 infection risk, as well as vaccine development timelines. Additionally, research highlights the potential benefits of home health care for COVID-19 survivors after hospital discharge.
A commentary discusses the need to weigh scientific validity against social value in COVID-19 vaccine development, highlighting concerns about long-term efficacy and safety. Vaccination efforts could intensify debates around early deployment, emphasizing the importance of addressing these issues.
A Danish trial found that wearing masks outside the home weakly supports lesser degrees of protection against SARS-CoV-2 infection, but cannot definitively exclude no effect. The study showed similar infection rates between mask and control groups despite public health measures in place.
A randomized controlled trial comparing laparoscopic and open liver surgery for patients with resectable colorectal liver metastases found no significant difference in 5-year survival outcomes. The study suggests that the laparoscopic approach may provide better short-term outcomes but does not jeopardize oncologic outcomes.
Researchers describe the rapid deployment of a virtual hospital program during the COVID-19 pandemic, finding potential benefits in providing additional inpatient capacity. Meanwhile, a study on 60-day postdischarge outcomes among patients hospitalized with COVID-19 reveals ongoing morbidity and financial loss for most survivors.
A new equation for estimating glomerular filtration rate (GFR) shows improved accuracy and precision compared to commonly used equations. The European Kidney Function Consortium's (EKFC) equation addresses limitations of existing methods and is suitable for a wide age range.
The American College of Physicians publishes COVID-19 news from Annals of Internal Medicine. Experts from the University of Pennsylvania and NYU Grossman School of Medicine discuss the legal, ethical, and clinical ramifications of restricting patient access to EUA-approved COVID-19 drugs and vaccines.