Articles tagged with Internal Medicine
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.
A study of emergency medicine doctors found that adult patients are charged 340% more than Medicare pays for services. The largest hospital markups disproportionately affect minorities and uninsured patients, highlighting a need for fairer and more transparent healthcare pricing.
A new study found that hospital-acquired anemia affects nearly a third of hospitalized patients, increasing the risk of death or readmission. The severity of anemia was independently associated with a 39% increase in readmission or death within 30 days after discharge.
A new study found that nearly half of seniors in Ontario who visited a family doctor for a non-bacterial infection received an unnecessary antibiotic prescription. The majority of prescriptions were for broad-spectrum antibiotics, which are associated with increased risk of adverse outcomes and antibiotic resistance.
A survey of physician moms found nearly 4 out of 5 respondents experienced discrimination, with gender and maternal discrimination prevalent. Women who reported maternal discrimination were more likely to value changes like longer paid maternity leave and breastfeeding support.
A study published in JAMA Internal Medicine found that patients are more likely to disclose their sexual orientation than previously thought, with nearly 78% of clinicians believing patients would refuse. Nonverbal self-report is the preferred method for collecting sexual orientation data, according to both patients and clinicians.
Recent guideline changes have led to disagreement among professional societies on best practices for mammography. Physician screening recommendations vary, with some recommending annual exams and others prioritizing biennial screenings.
The journal highlights several notable research findings, including the benefits of quitting smoking abruptly, low-dose aspirin for cardiovascular prevention, and statins in rheumatoid arthritis. These updates aim to promote excellence in medicine and improve patient outcomes.
Researchers at UT Southwestern Medical Center found that combining five simple tests provides a broader and more accurate assessment of heart-disease risk. The tests, including an EKG, blood tests, and imaging, better predict who will develop heart disease compared to standard strategies.
The American College of Physicians (ACP) issues recommendations for preventing and treating substance use disorders involving illicit and prescription drugs. Key findings include limited access to care, with only 18% of those needing treatment receiving it, and the need for expanded public health initiatives and improved prescribing pr...
A special issue of the Journal of General Internal Medicine reviews primary care innovation and suggests new models that prioritize population health and cost control. Experts highlight the importance of preserving trusting relationships between patients and primary care physicians to achieve better outcomes.
A new study published in JAMA Internal Medicine found that higher healthcare spending by physicians was not associated with better patient outcomes for hospitalized Medicare beneficiaries. The study suggests that policies targeting individual physicians within hospitals may be more effective in reducing wasteful spending.
A randomized, placebo-controlled trial found that anakinra did not reduce fatigue severity in women with chronic fatigue syndrome. The study's findings suggest that interleukin-1 inhibition may not play a role in CFS, contradicting previous studies.
A Yale-led study found racial disparities in Alpha Omega Alpha (AA) membership selection, with black and Asian medical school students less likely to be chosen than white students. The disparity suggests bias in the AA membership process, which could limit opportunities for minority medical students.
A single-payer health reform would provide comprehensive first-dollar coverage to all Americans, abolishing copayments and deductibles, while saving an estimated $504 billion annually in administrative costs. The proposal, published in Annals of Internal Medicine, also includes hard bargaining with drug companies over prices.
The American College of Physicians issues a guideline for treating nonradicular low back pain, recommending non-drug therapies such as superficial heat, massage, and acupuncture. For chronic low back pain, the ACP suggests exercise, multidisciplinary rehabilitation, and mindfulness-based stress reduction as initial treatment options.
A study found that seniors taking three or more brain-affecting medications increased by over 100% between 2004 and 2013, with falls and driving problems being major concerns. The combination of opioids, antidepressants, tranquilizers, and antipsychotics carries special risks for older adults.
A study by University of California San Francisco researchers found that installing a bedside interpreter-phone system improved understanding of healthcare procedures among patients with limited English. The system reduced errors and disparities in care, especially for Chinese- and Spanish-speaking patients.
A study found that online ratings and comments significantly increase doctor job stress, with 78% of physicians feeling the impact. Patients also use online reviews to make informed choices, but may be hesitant to share their own experiences due to concerns about bias.
The UT Southwestern Medical Center review article proposes an evidence-based medicine approach to prevent overtreatment of type 2 diabetes. It suggests balancing absolute benefits and harms with the physician's judgment and patient values, recommending more modest blood-sugar goals for frail and older individuals.
A recent study by the American College of Physicians found that physicians spend significantly more time on computer activities than direct patient interaction, taking up about half their workday. This has led to concerns over physician satisfaction, patient education, and increased malpractice risks.
A study published in Journal of General Internal Medicine found that fixed-dose combination pills work best to encourage patients with high blood pressure to stick to their prescribed anti-hypertensive medications. Patients on these combined pills were 9% more likely to be persistent in taking their medication, compared to those on sin...
The publication features original investigations, research letters and a commentary addressing financial conflicts of interest in various healthcare settings. The studies highlight the need for transparency and explicit adoption of COI frameworks to ensure trust in clinical guidelines.
A study found that US physicians charge significantly more than Medicare pays, with median charges 2.5 times higher. Regional variations were also significant, with some specialties and states facing much higher excess charges.
Medical students in Colorado express strong support for marijuana legalization, but hesitate to prescribe it due to limited data and training. Most believe further research is needed on its physical and mental health benefits.
A study published in JAMA Internal Medicine found that men and women who engage in physical activity on just one or two occasions per week have a lower risk of death from all causes, cardiovascular disease, and cancer. The 'weekend warriors' spent an average of 300 minutes per week doing moderate- to vigorous-intensity physical activity.
A population-based cohort study found that primary care physicians with higher ambulatory volumes deliver lower-quality diabetes care, while those with higher diabetes-specific volumes provide better care. The study's results suggest a clear association between physician volume and quality of diabetes management.
Patients enrolled in a program to address unmet socioeconomic needs saw significant improvements in blood pressure and cholesterol levels, according to a study by Massachusetts General Hospital. The Health Leads intervention helped patients with hypertension and elevated LDL cholesterol levels, but not diabetes.
A study of internal medicine residency program directors found that while most were satisfied with their current handoff strategies, implementation varied widely, ranging from 6 to 67 percent
A national cohort study found that patients using more than one health system had significantly higher rates of potentially unsafe medication prescribing compared to those using the Department of Veterans Affairs (VA) only. The prevalence of such prescribing was particularly high among dual users, suggesting a need for improved coordin...
The American College of Physicians survey found that internists frequently prescribe high-cost treatments with little benefit to patients. Despite guidelines recommending against these practices, many physicians continue to use them, reflecting a desire to err on the side of treatment.
A new research letter published online by JAMA Internal Medicine suggests that walking fewer than 900 steps per day is associated with hospitalization-associated functional decline in older hospitalized patients. The study included 177 older patients who walked less than 900 steps per day, with 55.4% experiencing functional decline.
A systematic review found that achieving brain-type natriuretic peptide (BNP) and pro-brain-type natriuretic peptide (NT-proBNP) predischarge thresholds is associated with reduced mortality and readmission in patients hospitalized for acute decompensated heart failure. The evidence was low-strength, but the studies consistently showed ...
A recent survey found that Asian Americans are the least likely racial or ethnic group in the US to receive type 2 diabetes screening, despite having a high risk of developing the disease. Only 47.1% of eligible Asian Americans received screening tests between 2012 and 2014.
Dr. Michael E. Charness has made significant contributions to understanding the effects of alcohol on the nervous system and has developed drugs that block alcohol toxicity. He is a leading expert in fetal alcohol spectrum disorders and has cared for patients with neurological disorders throughout his career.
The American College of Physicians recommends using corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout. The guideline also advises against long-term uric acid-lowering therapy in most patients after a first gout attack.
A study published in the Journal of General Internal Medicine found that frequent participation in multiple types of leisure activities reduces heart-related deaths among seniors. Engaging in low-intensity daily physical activity can provide cardiovascular protection.
A new study published in Journal of General Internal Medicine found that most elderly individuals who suffer a hip fracture will not regain their pre-injury level of physical activity or independence. The likelihood of recovery was particularly low for those over 85, with dementia, or multiple comorbid conditions.
A recent study analyzing data from the National Health and Nutrition Examination Surveys (NHANES) 2009-2014 found that celiac disease prevalence remained stable at 0.70%, while adherence to a gluten-free diet increased from 1.08% in 2009-2010 to 1.69% in 2013-2014.
A recent study reveals that many adults who screen positive for depression do not receive treatment, highlighting disparities in mental health care. The study found that only 28.7% of those screened positive for depression received any treatment, with certain groups facing lower rates of access to care.