A new study suggests that early initiation of annual breast cancer screening with MRI and mammography may reduce breast cancer mortality by half or more in female childhood cancer survivors previously exposed to chest radiation. The findings highlight the importance of MRI in reducing deaths from breast cancer in this population.
Taiwan's universities share their experience in safely reopening colleges and universities, highlighting effective public health strategies. Immigrant physicians in the US face unique challenges due to visa status, affecting their families' health and safety.
Researchers suggest routine use of N95 respirators for inpatient COVID-19 care, citing existing data as evidence. Worldwide step count decreases have been seen during COVID-19, with regional variability reflecting adherence to social distancing measures.
A systematic review and network meta-analysis suggest metformin-based therapy as a preferred first-line treatment for drug-naive patients with type 2 diabetes at low cardiovascular risk. Insulin regimens and GLP-1 RAs added to metformin-based background therapy produced the greatest reductions in hemoglobin A1c level.
Researchers report a lower incidence of COVID-19 among HIV-positive patients receiving tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) therapy. Further investigation is warranted to understand the findings' implications for HIV preexposure prophylaxis and randomized trials.
A commentary from Beth Israel Deaconess Medical Center reviews basic respiratory physiology and highlights the clinician's role in educating the public against relying on speech as a sign of adequate respiration. Data from studies of war and torture victims show that suffocation is a strong predictor of posttraumatic stress disorder.
Researchers reviewed multiple databases to examine the effectiveness of various masks in preventing respiratory virus infections. They found that N95 respirators may reduce SARS-CoV-1 risk versus surgical masks in healthcare settings, but applicability to SARSCoV-2 is uncertain.
The COVID-19 pandemic is causing deaths with forced separations that deny final goodbyes and traditional mourning rituals. Bereavement care is essential to offset the risks of psychological distress. Authors suggest words clinicians can say to bereaved family members and guidance on referrals.
A large retrospective cohort study found that flu vaccination was associated with a small increased risk for subdeltoid bursitis. Researchers suggest education and training on proper injection technique could prevent this adverse event.
The American College of Physicians (ACP) publishes a new policy paper condemning racism and violence against Black individuals, citing adverse individual and community health consequences. ACP offers specific solutions to increase transparency, accountability, and safer law enforcement practices.
The American College of Physicians (ACP) has issued new Practice Points on the effectiveness of masks for preventing COVID-19 disease. The guidelines emphasize the importance of N95 respirators in healthcare settings and recommend surgical masks for non-medical individuals to reduce transmission risk. ACP also emphasizes the need for c...
The American College of Physicians has updated its practice points on the use of chloroquine and hydroxychloroquine for COVID-19 treatment. Despite recent studies, there is still no conclusive evidence to support the use of these medications for either prophylaxis or treatment of coronavirus disease.
Annals of Internal Medicine publishes new COVID-19 research, highlighting the importance of high-quality clinical trials and informative multi-group trials to counteract misleading information. The journal also emphasizes the potential for the pandemic to transform medical care, education, and work.
A new study published in Annals of Internal Medicine finds that a 4-month rifampin regimen is cheaper and more effective than a 9-month course of isoniazid for treating latent tuberculosis. The treatment has the potential to change the way latent tuberculosis is treated, with significant cost savings for healthcare systems.
Researchers from University of Washington and Fred Hutchinson Cancer Research Center propose using multigroup, adaptively randomized trials to compare multiple COVID-19 interventions. This design may reduce adverse outcomes during trials and enable faster implementation of effective treatments.
Authors describe timely and targeted actions to prevent mental health crisis in overextended and stressed essential workers, citing Lorna Breen's tragic loss as a catalyst. The article emphasizes the need for clinicians to prioritize their well-being during the pandemic.
The Women's Preventive Services Initiative recommends screening for anxiety in women and adolescent girls to detect specific types of anxiety and co-occurring conditions. Researchers found strong evidence that screening instruments are moderately to highly accurate.
A recent study published in Annals of Internal Medicine explores the disproportionate impact of COVID-19 on ethnic minority communities, highlighting existing disparities in healthcare access and treatment. The authors offer a resilience approach to addressing these disparities, drawing parallels with the 1918 influenza pandemic.
Researchers at McGill University reviewed available research on SARS-CoV-2 antibody detection tests, highlighting key areas of ongoing research and proposing potential strategies for test implementation. They found that most serologic assays have minimal or no external validation, hindering assay selection and interpretation of results.
Researchers found asymptomatic persons account for approximately 40-45% of SARS-CoV-2 infections, emphasizing the need for symptomless testing. The pandemic has highlighted a shortage of infectious disease (ID) experts in the US, with nearly two-thirds of Americans living in counties with below-average ID physician access.
A group of American College of Physicians (ACP) leaders suggest using the organization's 'New Vision' policy paper to guide U.S. health care reform during and after the COVID-19 pandemic. The paper aims to improve access to care, reduce per capita health care costs, and simplify the healthcare system.
A randomized trial found that extended rituximab infusions were associated with lower relapse rates in patients with antineutrophil cytoplasmic antibody-associated vasculitis. Long-term rituximab use is considered an effective and probably safe treatment option for patients with AAV, according to the study's findings.
Researchers in Ontario, Canada, found that physical distancing measures can prevent COVID-19 resurgence. A systematic review on hydroxychloroquine and chloroquine for treating COVID-19 showed conflicting evidence on their effectiveness.
The COVID-19 pandemic has exacerbated mental health issues among healthcare workers, particularly those at higher risk for chronic stress. A recent commentary recommends that healthcare professionals prioritize their own mental well-being by seeking support from colleagues and resources.
A recent study published in Annals of Internal Medicine found that loss of smell and taste are common symptoms of COVID-19, particularly among hospitalized and ambulatory patients. The researchers suggest that anosmia may not be related to nasal obstruction or inflammation.
A single negative high-quality screening colonoscopy was associated with reduced colorectal cancer incidence and mortality. The study found a 90% reduction in CRC mortality over 17.4 years, suggesting that the current 10-year screening interval could safely be extended.
Researchers from McMaster University discuss cloth masks and ventilation techniques in reducing COVID-19 transmission. They conclude that noninvasive ventilation may reduce mortality but increase risk for healthcare workers.
Researchers from University Hospital of Toulouse treated a severely ill patient with COVID-19 using tocilizumab, a biological agent targeting inflammatory cytokines. The patient showed dramatic improvement in respiratory outcomes, suggesting potential benefits for patients with the most severe forms of COVID-19.
Researchers found that a short-term diet high in fruits and vegetables significantly lowers markers for subclinical cardiac damage and strain in adults without preexisting cardiovascular disease. The DASH trial data suggests that increased consumption of potassium, magnesium, and fiber may partly explain the observed effects.
Researchers investigated ACEIs/ARBs in adults with SARS-CoV-2 infection and found no increased risk. The use of these drugs is recommended for patients with COVID-19 unless further data show otherwise.
Researchers provide guidance on effective serious illness communication over video or telephone during the COVID-19 pandemic. They also report cases of pulmonary arterial thrombosis in COVID-19 patients with fatal outcomes, highlighting the need for improved understanding of SARS-CoV-2 infection.
The American College of Physicians has issued new Practice Points stating that hydroxychloroquine and azithromycin do not support COVID-19 prophylaxis or treatment. However, they may be used in clinical trials with informed decision-making. Additionally, research suggests that RT-PCR tests for SARS-CoV-2 have low sensitivity, particula...
Researchers investigate lopinavir and ritonavir's effectiveness for treating COVID-19, finding current dosing may be ineffective. Cytokine levels are reported in a patient with COVID-19 and acute respiratory distress syndrome, highlighting the potential role of cytokines in disease progression.
A 4-week course of acupuncture significantly increased self-reported relief and improvement of symptoms for patients with postprandial distress syndrome (PDS), a subtype of indigestion. The effects persisted through the 12-week follow-up without symptom relapse or rebound.
Healthcare workers face significant burdens from coronavirus infections, with increased risk associated with certain exposures. The journal Annals of Internal Medicine is publishing rapid reviews and living systematic reviews to keep up with emerging evidence during the pandemic.
Researchers found that L-thyroxine therapy did not improve symptoms, quality of life, or handgrip strength in older adults with subclinical hypothyroidism and high symptom burden. This study's results do not support routine use of L-thyroxine for this population.
A new commentary published in Annals of Internal Medicine emphasizes the importance of environmental cleaning during the pandemic. Environmental services personnel play a crucial role in preventing the spread of COVID-19, and their work is essential for patient safety.
Two new articles from Annals of Internal Medicine explore the availability of telemedicine services and pandemic surge modeling for COVID-19. A cross-sectional study found that many US hospitals lack existing telemedicine programs, while a podcast discussion highlights the importance of rapid investment in remote care infrastructure.
A new study from Annals of Internal Medicine reveals COVID-19 disparities affecting U.S. healthcare workers with risk factors for poor outcomes, as well as African Americans and Latinos disproportionately affected by the pandemic. The authors discuss lessons learned from prior experiences to reduce observed disparities.
Systematic reviews evaluate cognitive tests for Alzheimer's disease, biomarkers for neuropathologic Alzheimer disease, and prescription drugs for cognitive dysfunction. The findings suggest that certain brief cognitive tests are highly sensitive for distinguishing clinical Alzheimer-type dementia from normal cognition.
Researchers from Cincinnati Children's Hospital Medical Center describe ventilator triage policies developed during the COVID-19 pandemic. The American College of Physicians Ethics Committee also warns against using universal do-not-resuscitate orders and life-years approaches to ration resources, citing ethical concerns.
A commentary warns of a potential suicide epidemic in the US due to the COVID-19 pandemic, as gun sales skyrocket and social distancing disrupts support networks. The authors discuss ways to address this growing concern and mitigate its impact on public health.
Hospitalists are on the front lines of the COVID-19 pandemic, facing additional stressors including fear of illness, social distancing measures, isolation, and protracted uncertainty. The author of a commentary explains how hospitalists can manage their stress during this challenging time.
A survey of primary care physicians found that one-third did not support the use of medications to treat opioid use disorder (OUD), despite conclusive evidence. The researchers urge policy changes to increase the acceptance of and willingness to prescribe medications for OUD among primary care physicians.
Researchers from the National Institute for Infectious Diseases in Italy have reported an early detection of infectious SARS-CoV-2 in ocular fluids from a patient with COVID-19. The study found prolonged viral RNA detection, highlighting the need for continued vigilance in monitoring the pandemic.
Researchers developed an online tool to estimate the maximum number of COVID-19 cases manageable per day within a healthcare system's resources. The article also discusses pandemic surge models and their usefulness in public health decision-making during the pandemic.
A survey of 450 general practitioners in Lombardy, Italy reveals the challenges faced by GPs in preventing and managing COVID-19. The study highlights the need for effective clinician education to improve COVID-19 prevention measures.
The Institute for Health Metrics and Evaluation model has attracted significant attention from policymakers due to its predicted course of the COVID-19 pandemic. However, experts warn that the model's estimates are not without uncertainty and should be approached with caution.
Annals of Internal Medicine publishes new COVID-19 research, including a review on diagnostic tests and the critical role of community pharmacists in Taiwan's mask distribution system. Researchers also investigate the inflammatory response to COVID-19, identifying specific immune cells in patients with acute respiratory distress syndrome.
Researchers found that 70% of electronic consultations were appropriate and 81% associated with avoided face-to-face visits. This study suggests that e-consults can improve patient access to specialists and reduce travel costs.