Articles tagged with Internal Medicine
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.
The American College of Physicians has released a set of principles to guide patient partnership in healthcare, aiming to improve health outcomes, practice efficiency, and patient satisfaction. The principles emphasize the importance of patients and families being active partners in their care, contributing to system development and ed...
Genetic analysis of African ancestry found a correlation with increased risk factors for heart failure, including thicker left ventricles and higher ECG voltages. This study suggests that African ancestry may be associated with an increased risk of heart failure in young adults.
A new computer tool has been developed to identify patients with chronic pulmonary embolism (PE) who can be safely treated at home. The tool uses a sensitive cardiac injury marker, troponin, to measure the severity of PE and predict patient outcomes.
A survey of primary care clinicians found that most are willing to provide routine care for transgender patients, with a decrease in willingness among older clinicians. Factors such as personal exposure and transphobia levels influenced clinicians' willingness to provide Pap tests to transgender men.
Researchers developed a new marker that can accurately detect cardiac injury, reducing the need for costly and invasive stress tests. The test uses high-sensitivity cardiac troponin I (hs-cTnI) assays to measure troponin concentrations lower than conventional assays.
The American College of Physicians (ACP) has updated its policy recommendations for reducing gun-related injuries and death in the United States. The new guidelines build on existing policies, focusing on a public health approach to address this epidemic of gun violence.
Researchers at Karolinska Institutet discovered high levels of antiphospholipid antibodies in patients who suffered a heart attack without any autoimmune conditions. The study involved 800 patients and found that 11% had elevated IgG antibody levels, which is associated with blood clots.
A recent national survey of internal medicine doctors found that three-quarters reported financial ties to industry, with drug samples and food/beverage being the most common benefits. The study also revealed significant reductions in certain types of payments compared to a previous survey in 2009.
Alcohol consumption is common among patients with liver disease, associated with poor outcomes. The authors advocate for expanded treatment of alcohol use disorder in everyday clinical practice, including patients with advanced liver disease.
A new study from UT Southwestern Medical Center found that nearly 25% of genetic test results were reclassified due to evolving scientific knowledge. This reclassification can significantly impact patients' understanding of their cancer risk and treatment options.
Residents in certain specialties, such as urology and neurology, were more likely to report burnout symptoms. High levels of anxiety during medical school were associated with burnout symptoms during residency across all specialties.
A recent study published in Journal of Internal Medicine found that adhering to an anti-inflammatory diet was associated with lower risks of dying from any cause, cardiovascular causes, and cancer. Participants who closely followed the diet had an 18% lower risk of all-cause mortality compared to those who followed it to a lesser degree.
Two research letters examine the impact of Medicaid work requirements on recipients, estimating the number at risk of losing coverage and calculating associated spending. State-level estimates also provide insight into those meeting proposed work requirements.
A study found that modest reductions in age-adjusted, county-level death rates could have swung key US states to Secretary Clinton. Counties with higher Republican votes had higher age-adjusted death rates and increased deaths of despair.
Experts recommend states guide doctors in certifying patients who cannot work due to illness, and connect Medicaid enrollees with job training and support services. States should also consider fluctuating work patterns when implementing reporting requirements.
A study found that patients are given little time to explain their concerns before being interrupted by doctors. Primary care doctors tend to interrupt less than specialists, who may skip the introductory step due to familiarity with the condition. The pressure to rush consultations affects patient-centered care.
A recent study found that only 2% of trials assessing the safety or efficacy of probiotics, prebiotics, or synbiotics adequately reported key safety components. The researchers concluded that the lack of safety data makes it challenging to accurately determine their safety profile and make informed decisions for patients.
A web-based health behavior change support system improved weight loss and waist circumference reduction for up to 2 years. HBCSS, combined with cognitive behavioral group therapy or as a standalone treatment, offers a personalized approach to obesity treatment.
A recent patient study found that more than half of hospital patients who had a urinary catheter experienced complications, with non-infectious problems being five times more common than UTIs. The study highlights the importance of avoiding indwelling catheters and removing them as soon as possible to prevent these issues.
A recent clinical trial has shown that tamsulosin is not effective in promoting the passage of ureteral stones, contradicting previous small studies. The study's findings suggest that the medication may be beneficial for specific subgroups of patients with larger or distal stones.
Primary care providers report that the Healthy Michigan Plan has helped patients manage their health, detect problems early, and improve their ability to work and live independently. The plan's coverage has also led to better adherence to prescribed medicines and improved emotional well-being among patients.
In patients with congenital heart disease, atrial arrhythmias like atrial fibrillation occur at younger ages due to degenerative and progressive changes. Advanced imaging and individualized therapeutic plans using pharmacologic therapy, catheter-based ablation, and surgical therapies can help manage these conditions.
A study by UT Southwestern Medical Center found that financial strain is the primary factor influencing health care decisions for low-income patients. The researchers recommended that physicians take a proactive approach to recognize and address financial strain in their patients, rather than misinterpreting it as noncompliance.
Dr. Jeffrey H. Samet, an internationally recognized expert in addiction medicine care and research, has been awarded the American College of Physicians' Richard and Hinda Rosenthal Award #1. He is being recognized for his innovative work in developing theory-based behavioral interventions to address substance use disorders.
The American College of Physicians is calling for a revised approach to performance measurement, citing 32 valid and 30 invalid measures in Medicare's MIPS program. The ACP analyzed 86 performance measures and found that many were inadequately specified, leading to misclassification of high-quality care as low-quality care.
The USPSTF recommends against daily supplementation with vitamin D and calcium to prevent fractures in men and premenopausal women. However, they suggest these supplements may be beneficial for postmenopausal women, as current scientific evidence is insufficient for the general population.
Researchers found that organs from overdose deaths have noninferior outcomes to those from trauma or natural death, but may carry higher risks of HIV and hepatitis transmission. Optimizing their use could help address the organ shortage, but caution is needed due to small potential risks.
Researchers found that oral sirolimus treatment significantly improved pulmonary function and reduced carcinoid tumor volume in three patients with DIPNECH syndrome. The study provides promising evidence for sirolimus as a viable treatment option for this rare condition.
Kurt Kroenke, MD, has received the Robert J. Glaser award for his significant impact on modern primary care through his research on symptom management, depression, anxiety, and chronic pain. His work has led to the development of reliable measurement tools and innovative approaches to optimize pain care effectiveness.
The American College of Physicians releases a new position paper advising physicians on ethical obligations when participating in short-term global health experiences. Key findings include the importance of partnering with local leaders and minimizing potential burdens on local communities.
A recent study found that e-cigarette users were less likely to abstain from tobacco at 6 months compared to non-users. However, this finding may not be representative of the general population, and more research is needed to determine the efficacy of e-cigarettes in smoking cessation.
A new study reveals that U.S. South Asians with Type 2 diabetes consumed fewer beneficial nutrients than healthy South Asians, including dietary fiber and essential vitamins. The research highlights the need for improved dietary habits to manage blood cholesterol and blood pressure levels.
A new special issue of the European Journal of Internal Medicine presents a comprehensive overview of current evidence for medical cannabis and derived products. The studies highlight its effectiveness in pain relief and potential benefits for elderly patients, calling for further research to improve the evidence base.
The new guidelines provide updated clinical recommendations for treating strangles in horses, including a shift away from bacterial culture as the gold standard and new methods for determining disease-free status. The consensus statement also outlines best practices for quarantine, examination, and biosecurity protocols to prevent dise...
The American College of Physicians recommends reinforcing formal curricula with hidden cultural lessons in medical education. This includes modeling empathy, encouraging reflection, and promoting learner and clinician wellness. The goal is to align positive hidden curricula with formal curricula and foster respect, inquiry, and honesty.
A study by UT Southwestern researchers found that only half of older adults are transferred to long-term acute care (LTAC) facilities due to illness severity or complexity. Many others are sent based on hospital preferences and regional trends, potentially leaving them eligible for less expensive post-acute care settings.
A UTSW study found that inhibiting glucagon action has potent anti-diabetic effects, reducing negative fat tissue impacts and improving cardiac function. The research may advance understanding of diabetes drugs' benefits for heart health.
A new report from NASEM outlines a framework for preventing alcohol-impaired driving fatalities. The framework includes highly effective interventions and emerging opportunities to reduce traffic-related deaths.
A structured exercise program reduces major mobility disability in both frail and nonfrail patients, benefiting all older adults. Researchers found that physical activity can improve the ability to rise from a chair and reduce the risk of frailty.
A new study establishes expert consensus on managing concerning behaviors in patients taking opioids for chronic pain, including assessing risk and safety concerns, identifying pain symptoms, and providing patient education. The study also highlights the importance of referral to other pharmacologic and non-pharmacologic therapies.
A study of over 4,000 Michigan Medicaid enrollees found that nearly half are employed, while 11% are unable to work due to serious health issues. Those who cannot work face significant health challenges and may be more likely to experience worsening conditions without treatment
A new medical note system called 'OurNotes' has the potential to promote patient engagement, improve patient-centered care and collaboration between patients and providers. The study suggests that inviting patients to co-produce their own notes may help reduce documentation burdens on clinicians.
A recent study by Saint Peter's University Hospital found that US resident physicians are unprepared to counsel patients on medical cannabis, citing concerns over safety and addiction potential. The study highlights the need for further education among resident physicians in this area.
A new study published in JAMA Internal Medicine reveals that low wealth is associated with higher risks of death and disability among older adults in the US and England. Increasing wealth for those with the least can lead to gains in life expectancy and function.
A large-scale study involving over 3 million Danish and Swedish adult women found no association between HPV vaccination and serious chronic diseases. However, the vaccine may increase the risk of developing celiac disease, particularly in Denmark where the condition is underdiagnosed.
The American College of Physicians urges physicians to make a public commitment to talk to their patients about firearms and counsel them on safe firearm behaviors. Physicians who commit to this action can find resources and information in the growing literature.
Compounded bioidentical hormone therapies are not FDA-approved, lack quality control, and have the same risks as FDA-approved hormone therapy products. Women often unknowingly choose these over FDA-approved options due to misconceptions about safety and efficacy.
A new study published in JAMA Internal Medicine found that game-based interventions can increase physical activity among adults. In a 12-week clinical trial, participants who engaged with gamification elements showed significant improvements in step goal achievements and average daily steps compared to those in the control group.
A study by UT Southwestern Medical Center found that clinicians' prior image-ordering habits and equipment ownership are strong indicators of unnecessary MRI orders. This highlights the need for physicians to offer financially responsible care, particularly in cases of uncomplicated back pain and headaches.
A Massachusetts General Hospital study suggests that participating in the Supplemental Nutritional Assistance Program (SNAP) can lower annual health care costs by $1,400 per person. SNAP provides a monthly benefit to purchase certain food products and has been found to reduce food insecurity.
Experts outline steps hospitals can take to reduce risk, including workforce training, patching operating systems, and reporting attacks promptly. However, full security is unlikely to be achievable due to the complexity of modern hospital systems.
A new study reveals that up to 11% of older Americans with well-controlled diabetes are being overtreated, while around 7% are undertreated. The research emphasizes the need for personalized care in treating diabetes in older patients.
A study published in Annals of Internal Medicine found that excessive sedentary time, regardless of exercise habits, significantly increases the risk of death. Taking regular movement breaks can help mitigate this effect.
A recent study published in Annals of Internal Medicine found that neighborhood socioeconomic position is a crucial predictor of cardiovascular risk. The model used to predict this risk systematically underestimated the negative effects of living in disadvantaged neighborhoods, highlighting the importance of considering ecologic circum...
A study of dual-physician couples found that women with children worked significantly fewer hours than those without children. Men in these couples did not exhibit the same reduction in work hours as their female partners. The authors suggest societal expectations and specialty factors may contribute to these findings.
A study of nearly 2200 older patients found that 44% were prescribed antiplatelet drugs, with 52% of primary prevention patients overprescribed and 31% of secondary prevention patients underprescribed. This highlights the need for personalized treatment strategies in this patient population.
A new study by Duke University found a connection between ozone pollution and cardiovascular health in Chinese adults. Exposure to ozone was linked to increased platelets, elevated blood pressure, and other factors that contribute to cardiovascular disease.
Researchers found a 12 percent decline in sodium content of households' purchases over the 15-year period, with declines observed for all top food sources of sodium. However, less than 2% of U.S. households had optimal sodium density, highlighting the need for continued efforts to reduce sodium in packaged foods.