Articles tagged with Internal Medicine
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.
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 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...
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.
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 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.
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 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.
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
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 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...
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.
A recent study published in Journal of General Internal Medicine found that hospitals with adequate staffing levels, particularly registered nurses, experience reduced restraint use. The research suggests that the type of nursing staff rather than just total staffing is a crucial factor in preventing restraints from being used.
A US study published in the Journal of General Internal Medicine found that prescribing short-acting opioids with no refills to opioid-naive patients significantly reduces the risk of long-term dependency. The study analyzed data from Oregon, which has the highest rate of non-medical opioid use in the US.
A study published in JAMA Internal Medicine found that consuming more plant-based protein was associated with a lower risk of death from all causes and cardiovascular disease. The researchers observed significant health benefits when substituting animal protein with plant protein, particularly from processed red meat.
Researchers at Yale University found that only a small percentage of Olympic athletes, spectators, and visitors will bring the Zika virus back to their home countries.
A survey of medical students found that nearly all reported tracking former patients in electronic health records to confirm diagnoses and follow up on progress. However, many expressed ethical concerns about accessing patient records without institutional direction.
A national survey found that over half of US physicians have withheld medical interventions due to cost concerns. Solo practitioners and those with conservative leanings were less likely to ration treatment options. The study highlights the complexities of resource utilization for healthcare providers in the US.
A systematic review of 69 studies found that VA facilities offer similar or superior quality care in some areas, such as mortality rates and preventive services. The study suggests that the VA healthcare system compares favorably with other health care settings.
Female academic physicians at public medical schools received lower average salaries compared to their male peers, with a $51,315 difference in unadjusted analyses. Adjusting for factors like faculty rank, age, and specialty narrowed the gap, but a $19,878 difference remained.
A national study found lesbian, gay, and bisexual adults experience significant health disparities, particularly in mental health and substance use. The study suggests that minority stress, including exposure to interpersonal and structural discrimination, contributes to these health outcomes.
Long-term statin therapy reduces cardiovascular events in patients with ischemic heart disease who have moderate low-density lipoprotein cholesterol levels, but not those with high LDL-C levels. The study suggests that a blanket principle of lower LDL-C being better for all patients may not apply.
A recent study from the University of Vermont found that a simple IVR system can encourage primary care doctors to discuss patients' drinking habits. Over half of participants reported having the discussion, and those who did were more likely to receive an alcohol-related recommendation from their provider.
A study found that Army personnel were most at risk for violent suicide among active duty enlisted service members. Firearms accounted for 62% of suicides with a known cause of death. The results suggest that infantry and special operations job classifications may be more likely to use firearms to commit suicide.
UT Southwestern researchers challenge long-held beliefs on acid reflux damage, finding that inflammatory response and cytokine secretion are the main causes of esophageal damage. The study could lead to novel GERD treatments targeting these proteins.
A new study published in JAMA Internal Medicine found that frequent attendance at religious services was associated with a lower risk of death for women from all causes, cardiovascular disease, and cancer. Women who attended services more than once a week had a 33% lower risk of death compared to those who never attended.
A study from the University of Colorado Anschutz Medical Campus found that long-term participation in a national weight-loss program led to significant weight loss and improved health outcomes. The researchers followed over 65,000 participants who joined the Take Off Pounds Sensibly (TOPS) program between 2005 to 2010.
Cognitive behavioral therapy is recommended as first-line treatment for adults with chronic insomnia, according to the American College of Physicians. The new guideline also suggests a shared-decision making approach if therapy alone is unsuccessful, and notes that medication may have fewer harms than sleep medications.
Climate change will have devastating consequences for public and individual health unless aggressive, global action is taken to curb greenhouse gas emissions. ACP recommends that medical schools incorporate climate change-related coursework into curricula.
A study of nonurgent ED visits found that diagnostic services and procedures were provided in a significant percentage of cases, suggesting potential overuse or uncertainty among patients and healthcare professionals. The findings also highlighted similarities between nonurgent and urgent visit symptoms and diagnoses.
The American College of Physicians calls for immediate global action to combat the health impacts of climate change, including heat-related illnesses and malnutrition. A new policy paper highlights the need for physicians to educate themselves and their patients about climate change's effects on human health.
A recent study discovered a genetic mutation linked to X-linked reticulate pigmentary disorder (XLPDR), a rare systemic disorder affecting 14 known families worldwide. The mutation affects the POLA1 gene, involved in DNA replication, and alters cellular mechanisms leading to aberrant splicing and immune responses.
A study by Mitesh Patel found that combining individual and team incentives led to a significant increase in physical activity. Participants who received rewards for both individual and team performance averaged more steps per day than those with individual-only rewards.
A study published in Annals of Internal Medicine found that quitting smoking abruptly is more likely to lead to long-term success than gradual reduction. After assessing 697 smokers for four weeks and six months, the research revealed a 25% higher quit rate for those who stopped all at once.
A study found that an instant blood pressure app underestimated higher BPs and overestimated lower BPs, raising concerns about its accuracy. The app's inaccuracy may lead to false reassurance for individuals with hypertensive BP levels.
Researchers analyzed data from 10 Michigan hospitals to show significant variation in peripherally inserted central catheter (PICC) use, with nearly one in four PICCs removed within five days. The study also found wide variation in complication rates, including serious and life-threatening events such as blood clots and infections.
A study published in the Journal of the American Medical Informatics Association found that follow-up emails from doctors are crucial to keeping patients informed about their care. Patients who continued receiving reminders tended to access their notes more frequently, leading to better health outcomes.
A recent study published in JAMA Internal Medicine found that remote telemonitoring did not significantly reduce all-cause 180-day hospital readmissions among heart failure patients. Despite this, the intervention group reported improved quality of life at 180-days compared to usual care patients.
A report published in Annals of Internal Medicine describes the first known case of Zika virus in a US resident following travel to Costa Rica. The traveler exhibited symptoms and had test results that indicated Zika infection, highlighting the need for travelers to avoid day-biting mosquitoes.
The American College of Physicians recommends cognitive behavioral therapy (CBT) and second-generation antidepressants (SGAs) as similarly effective treatments for adults with major depressive disorder. CBT is a reasonable approach for initial treatment, particularly when discussing treatment effects and patient preferences.
Researchers found that guideline-concordant care, including mental health services and substance abuse treatment, can significantly reduce the risk of death for patients on opioid painkillers. Patients who received these services were 50% less likely to die within six months.
Experts offer guidance for pregnant women to avoid mosquitoes, while debating the need for annual physicals in patients. The ACIP releases its 2016 Recommended Adult Immunization Schedule with major changes to HPV and pneumococcal vaccines.
A randomized clinical trial found that mailing free nicotine patches to smokers without behavioral support increased 30-day smoking abstinence at six months compared to those who received no intervention. The study suggests general support for direct-to-smoker programs with free mailed nicotine patches.
The study, published in JAMA Internal Medicine, examines the complex processes shaping dialysis timing and suggests opportunities for patient-centered approaches. The research reveals interrelated factors, including physician practices, precipitating events, and patient-physician dynamics.
Enrollees in high-deductible health plans show no difference in considering alternative care or comparing costs with those in traditional plans. Despite perceptions of price differences and quality disparities, HDHP enrollees don't shop around for better deals.
Leading medical journals propose a mandate on clinical data sharing to improve the benefit to society from clinical trials. The ICMJE defines a clinical trial as any research project that prospectively assigns people to an intervention, and believes there is an ethical obligation to share data generated by interventional clinical trials.
After a nonfatal overdose, nearly 3,000 patients continued to be prescribed opioids, with 70% receiving prescriptions from the same provider who wrote them before. Patients taking high dosages were twice as likely to experience another overdose after discontinuing opioid use.