Articles tagged with Internal Medicine
The article provides guidance on supporting clinicians during the COVID-19 pandemic. Key findings highlight the importance of maintaining a patient-centered approach and adapting to new clinical challenges.
According to a new study, accidents involving drivers with low blood alcohol concentrations are more likely to cause harm to others than drivers with levels at or above the limit. The study found that stringent alcohol policies can reduce the likelihood of fatal accidents involving drivers with all levels of alcohol blood concentration.
Researchers analyzed lung tissue from a COVID-19 patient to investigate histopathologic changes and SARS-CoV-2 immunostaining. The study found distinct patterns of immune cell activation and inflammation, shedding light on the disease's pathophysiology.
Two new articles published in Annals of Internal Medicine provide guidance on how US hospitals can prepare for the ongoing COVID-19 pandemic. The first article offers ideas for protecting hospitals from the invisible threat of coronavirus, while the second article provides recommendations for preparing hospitals for a surge in cases.
A new branded HIV pre-exposure prophylaxis (PrEP) drug, emtricitabine/tenofovir alafenamide (F/TAF), has been approved but found not to be cost-effective compared to generic formulation F/TDF. The study suggests that the high cost of F/TAF may undermine efforts to expand access to PrEP for the most vulnerable populations.
Researchers at the University of Texas at Dallas identified a molecule that induces coughing in tuberculosis patients, providing a potential target for treatment and prevention. The discovery could help reduce the spread of TB, which kills over 1.3 million people worldwide annually.
A study published in Journal of Internal Medicine found that weight loss surgery, especially gastric bypass, increases the long-term risk of bone fractures. The rate was highest among patients who underwent gastric bypass, with a 2.58-times higher fracture risk compared to non-surgical obesity care and other bariatric surgery methods.
Researchers found a small mortality benefit for continuing mammography screening in women between 70-74 years old, but no benefit for those over 75. Women who continued screening were less likely to receive aggressive therapies for breast cancer.
The ACIP released its 2020 Recommended Immunization Schedule for adults with changes to vaccine administration and shared clinical decision-making. The schedule includes new instructions for discussing HPV vaccination, pneumococcal conjugate vaccines, and meningitis B vaccines.
The American College of Physicians (ACP) has endorsed single-payer Medicare for All, reflecting growing support among physicians. The endorsement coincides with an open letter signed by over 2,000 physicians, including prominent figures in American medicine.
A recent study published in Annals of Internal Medicine found that adults with type 2 diabetes who were newly prescribed SGLT2 inhibitors had a lower rate of gout compared to those prescribed GLP1 agonists. This suggests that SGLT2 inhibitors may be effective in reducing the risk of gout among patients with type 2 diabetes.
States with Medicaid work requirements have higher opioid overdose death rates and fewer substance use disorder treatment facilities. Increasing access to evidence-based opioid addiction care is crucial for individuals with these conditions.
A cohort study found that preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations were independently associated with vascular death or myocardial injury at 30 days after surgery. Preoperative NT-proBNP thresholds improved discrimination and risk stratification for patients undergoing noncardiac surgery.
The Michigan Medicaid expansion program successfully doubled access to primary care and increased the discussion of healthy behaviors among low-income residents. According to new studies, nearly 90% of enrollees reported reduced stress and worry due to HMP coverage, with many going without dental care they needed before enrollment.
David Coleman, MD, will receive the Robert H. Williams, MD, Distinguished Chair of Medicine Award from the Association of Professors of Medicine (APM) for his exceptional leadership as chair of the Department of Medicine at Boston University School of Medicine and physician-in-chief at Boston Medical Center.
The American College of Physicians (ACP) has issued policy recommendations aimed at mitigating the rising costs of prescription drugs, including increasing transparency and lowering out-of-pocket costs for patients. The recommendations also focus on improving access to affordable medications and addressing issues in public health plans.
A three-year longitudinal study found that having a hematologist mentor during medical education is associated with an increased likelihood of fellows specializing in hematology. Fellows who co-authored papers or engaged in research activities with mentors in hematology were more likely to pursue careers in the field.
Researchers from Brigham and Women's Hospital analyzed national data on the prevalence of diabetes and the number of internal medicine specialists in each U.S. state. They found that cardiologists were the highest represented specialists, suggesting they are well-positioned to provide optimal care for patients with diabetes.
A systematic review and meta-analysis found that nonpharmacologic treatments, such as massage and touch therapy, were more effective than pharmacologic treatments in reducing aggression and agitation in adults with dementia. The authors recommend prioritizing nonpharmacologic approaches over medications due to potential harms associate...
A panel of experts based on rigorous systematic reviews found little to no health benefits for reducing red or processed meat consumption. Most adults can continue their current levels of red and processed meat intake without negative health effects.
This study examined changes in internal medicine subspecialty choices from 1991 to 2016, with women and men showing varying trends across nine subspecialties. The findings suggest shifting interests in areas like geriatric medicine and hematology and oncology, potentially driven by demographic changes.
A new study finds that drawing blood cultures after starting antimicrobial treatment can result in a significant loss of available clinical information. The study suggests that drawing blood cultures prior to treatment may be more effective in identifying the bacteria causing the infection and selecting the right antibiotic.
Researchers discovered that patients coming off chronic opioid prescriptions were three times more likely to die of an overdose in the years that followed. This alarming outcome has raised concerns about the policy recommendations aimed at reducing opioid prescribing, highlighting the need for systems to protect patients.
A new study published in Journal of Internal Medicine found that coffee consumption is linked to a lower risk of developing symptomatic gallstones. Drinking more than six cups of coffee per day was associated with a 23% reduced risk, while one extra cup per day had a 3% lower risk.
A Regenstrief Institute researcher suggests redesigning EHR platforms to clearly access relevant data, reducing distractions and information overload. His 13 principles aim to combat inefficiencies and improve EHR functionality for better clinician-patient care.
A poor diet caused permanent vision loss in a 14-year-old patient, according to a case report published in Annals of Internal Medicine. Vitamin B12 deficiency and inadequate nutrient intake led to nutritional optic neuropathy, a rare condition that can cause irreversible blindness if left untreated.
A systematic review found moderate-strength evidence supporting face-to-face CBT in reducing suicidal ideation, as well as low-strength evidence suggesting DBT's effectiveness. Pharmaceutical treatments like ketamine and lithium showed promise in reducing suicidal ideation and suicide rates, respectively.
A new study found that people with mild cognitive impairment (MCI) who have a heart attack are less likely to receive evidence-based treatment. Despite this, researchers emphasize that MCI does not necessarily mean reduced benefit from treatment and that patients should still receive care when indicated.
A new study examines the effectiveness of extreme risk protection orders (ERPOs), also known as 'red flag' laws, in preventing mass shootings. The research analyzed 21 cases and found that ERPOs had prevented all threatened shootings, with no other homicides or suicides by persons subject to the orders.
The American College of Physicians (ACP) has developed a rigorous process for disclosing interests and managing conflicts of interest to ensure transparency, proportionality, and consistency in clinical guideline development. The process applies to all individuals involved in ACP's clinical guidelines and guidance statements.
A recent survey of over 24,000 internal medicine residents found that about 14% reported being bullied, with foreign-born trainees experiencing higher rates. The study also linked bullying to burnout, depression, and poor performance on exams.
Patients who receive addiction medicine consultation in hospital are twice as likely to participate in treatment for substance use disorder after discharge. OHSU's innovative program has significantly increased treatment engagement, leading to better health outcomes.
A survey of internal medicine residents found that many reported being bullied during their training, which had a significant impact on their mental health and overall well-being. The study highlights the need for a safe and supportive learning environment in medical education.
The American College of Physicians, along with leading physician and public health organizations, calls for policies to reduce firearms-related injuries and deaths. Comprehensive criminal background checks, research into the causes of firearm violence, and improved access to mental health care are recommended.
A new study by Brigham and Women's Hospital found that prescribed opioids are associated with a nearly threefold increase in overdose rates for individuals without their own prescriptions. Family members on the same health insurance plan have access to these medications, posing a significant risk of accidental exposure or misuse.
A retrospective cohort study found that patients who received opioids for the first time while hospitalized had double the risk of continuing to receive opioids for months after discharge. Researchers reviewed electronic health records of 191,249 hospital admissions and found that almost 6% of patients receiving opioids during their ho...
A study by Regenstrief Institute researchers found that only 30% of patients reported having some form of advance directive, but only 16% had one on file in their electronic medical record. This lack of documentation can lead to complex situations for care providers and loved ones.
A new study by Johns Hopkins researchers found that five-star hospitals offer fewer services compared to non-five star hospitals. Five-star hospitals are less likely to have emergency departments, intensive care units, and other specialized services.
A study published in Annals of Internal Medicine found that women who were denied an abortion due to gestational age limit reported worse health 5 years later compared to those who underwent an abortion. The study also found similar physical health outcomes between women who had abortions in the first or second trimester and those who ...
The American College of Physicians has released a new paper outlining its methods for developing high-quality, evidence-based clinical policy papers. The methodology ensures that recommendations are based on the best available scientific evidence, considering clinical benefits, harms, costs, and patient values. ACP's approach includes ...
The American College of Physicians has released a position paper outlining professional duties and principles for responding to physician impairment. The guidelines emphasize the importance of rehabilitation and reintegrating impaired physicians into medical practice while ensuring patient safety.
A new essay published in Annals of Internal Medicine argues that physicians often have to make difficult decisions when faced with extreme political pressures. The author shares a personal story about caring for a pregnant woman who was forced to carry a baby without a brain, highlighting the need for compassion over 'choice' in patien...
Researchers found that nearly half of callers with Medicaid coverage were denied appointments due to lack of available clinicians. However, wait times were generally less than two weeks, indicating opportunities to improve access to buprenorphine treatment.
A new study by Brigham and Women's Hospital found that older women who took 4,400 steps per day had significantly lower mortality rates compared to those taking 2,700 steps per day. Risk of death continued to decrease with more steps taken, leveling off at around 7,500 steps per day.
A mathematical model found that physician burnout costs the US healthcare system approximately $4.6 billion per year, with potential economic value for reducing burnout through policy and organizational efforts. Accessing patient notes may also improve medication adherence and patient comfort.
Researchers at Johns Hopkins Medicine found that physicians in ambulatory surgery centers and physician offices were more likely to schedule different-day procedures, resulting in higher costs. The study suggests that financial incentives may be a contributing factor to this trend.
A new survey of over 200 internal medicine residents suggests that better training is needed to increase the prescribing of PrEP, a proven tool to prevent HIV transmission among high-risk individuals. The study's findings highlight the importance of improving residency training programs nationwide.
The American College of Physicians recommends strengthening the Affordable Care Act to address gaps in coverage and ensure universal access. ACP calls for bolstering the insurance market, expanding Medicaid, and increasing competition to provide quality care for all Americans.
A new RAND Corporation study finds that primary care services account for only 2.12% to 4.88% of total medical and prescription spending among Medicare beneficiaries. This estimate is lower than previous studies, and highlights the importance of investing in primary care for better outcomes and lower costs.
A new study finds that hospitals serving richer patient populations will face increased financial penalties under the revised system, while those with poorer patients will see reduced penalties. The changes aim to address concerns about the original program unfairly penalizing safety-net hospitals.
Researchers found that uninsured and Medicaid patients are more likely to be transferred from emergency departments, discharged without admission, or admitted to hospitals with limited critical care services. Financial incentives for hospitals may contribute to these disparities in access to acute hospital care.
Dr. Lauren Ferrante's research identifies promising markers of poor functional recovery in ICU survivors, which could help target older adults for interventions to improve function after ICU care. Her work aims to aid recovery, prevent disability, and reduce deaths following serious hospitalization.
A study of 9,048 individuals in Sweden found that respiratory, skin, and urogenital infections significantly increase the risk of developing Sjögren's syndrome. The findings support the hypothesis that environmental triggers play a crucial role in its development.
A new study from Duke University found that patients shed more weight when doctors give specific instructions, such as tailored behavioral goals and educational material, compared to generic advice. Patients who received empathetic care also lost more weight on average.
A Massachusetts General Hospital study found that international medical graduates care for Medicare patients with more complex medical needs than those cared for by domestic graduates. The report's findings have implications for immigration policies and access to primary care for the sickest Americans.
Research at UT Southwestern Medical Center found exercise reduces visceral fat more significantly than medication per pound of body weight lost. Exercise can melt visceral fat, lowering risk of heart disease and diabetes.
A new study by Michigan Medicine found that nearly half of people covered by expanded Medicaid felt their physical health improved, while more than a third reported improvements in mental or dental health. Enrollees who were employed also reported better job performance and had easier times looking for jobs.
A single workout can activate neurons influencing metabolism for up to two days, according to a mouse study from UT Southwestern Medical Center. The finding provides an avenue to explore potential treatments to improve glucose metabolism in diabetes patients.
One in four patients with type 1 or 2 diabetes have reported using less insulin than prescribed due to high costs. This underuse of insulin is often accompanied by poor glycemic control and difficulty affording other diabetes management equipment.
A new study found that only 21% of health surrogates actually know what an older adult would want in the event of a serious illness, despite 75% feeling confident in their knowledge. The researchers emphasize the need for improved advance care planning and communication between patients and their health surrogates.