Articles tagged with Internal Medicine
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.
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.
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.
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.
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.
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.
A new study suggests that patient-administered antimicrobial infusions at home can achieve similar or better outcomes compared to traditional healthcare-delivered options. The research found lower rates of hospital readmission and similar mortality rates among uninsured patients who self-administered antibiotics at home.
A new study published in JAMA Internal Medicine found that while specialty prescribers concentrated opioid prescriptions, general practitioners wrote the most total prescriptions among Medicare prescribers. The authors analyzed 2013 Medicare data and focused on opioid prescriptions containing over 20 different opioids.
A new model, POISED, aims to balance technology use with human connection. Key findings include: Using computers in exams can compromise patient safety and relationships if not implemented correctly.
The American College of Physicians recommends prescribing generic medications when available, as it improves health outcomes, reduces harm, and eliminates wasteful practices. Generic substitution can lead to better long-term medication adherence and save patients $1.4 billion annually.
A systematic evidence review and meta-analysis found that peripheral thermometers have poor clinical accuracy and sensitivity compared to central thermometers. Central thermometers, such as rectal or bladder thermometers, are considered the gold standard for accurate temperature measurement.
Researchers found that white coat and masked hypertension are associated with increased rates of heart attacks, strokes, and heart failure. These conditions were also linked to aortic stiffness and kidney damage.
A study found that physician-hospital financial integration is associated with increased spending and prices for outpatient care, but not necessarily more efficient care. The integration led to a $75 per-enrollee increase in annual outpatient spending from 2008 to 2012.
The Guidelines International Network has issued 9 principles to address financial, intellectual, and personal conflicts of interest in clinical practice guideline development. The principles emphasize the importance of disclosure and management of COI to ensure trustworthiness of guidelines.
A nationally representative study found racial/ethnic minorities and unemployed individuals spent more time traveling to, waiting for, and receiving medical care. Face-to-face time with physicians averaged 20.5 minutes and did not vary by patient race/ethnicity.
Physicians should use validated clinical prediction rules to estimate pre-test probability of PE. In low-risk patients, D-dimer testing can provide additional risk stratification. Imaging is indicated for high-risk patients or those with a high clinical presentation. Age-adjusted D-dimer thresholds can help determine imaging necessity.
A new comprehensive guide, MAGIC, offers a framework for clinicians to pick the right device for each adult patient, reducing complications and improving safety. The guide provides color-coded charts and algorithms to indicate appropriate or inappropriate use of IV devices.
A provocative essay in Annals of Internal Medicine exposes doctors' disrespect towards vulnerable patients, highlighting shocking clinical experiences. The author's anonymity protects patient privacy, but raises questions about medical ethics and accountability.
Researchers found limited evidence that web-based interventions reduced alcohol consumption in adults and college students who screened positive for hazardous alcohol use. Higher intensity interventions with human support are suggested to have greater benefits.
A new study estimates the cost of implementing revised physician board recertification requirements will be a significant burden on physicians and patients. The study found that most costs arise from the time required for physicians to fulfill requirements, rather than fees payable to the American Board of Internal Medicine.
Healthcare professionals and consumers can voluntarily report adverse drug events directly to the FDA or the manufacturer, but about 10% of serious and unexpected adverse events are not reported under federal regulations. The study analyzed over 1.6 million reports and found that patient death was associated with delayed reporting.
A new Penn study found that internal medicine residents are twice as likely to prescribe expensive brand-name statins when supervised by senior physicians who also use them. The study's findings represent an opportunity to improve value in healthcare spending and highlight the importance of redesigning graduate medical education.
A study published in Annals of Internal Medicine found that 10% of health care providers write an antibiotic prescription for nearly every patient (95 percent or more) who walks in with a cold, bronchitis or other acute respiratory infection. This variation is driven by individual provider habits rather than differences in patient char...
Researchers at UT Southwestern Medical Center found that introducing an enzyme called ceramidase in diabetic mice rapidly improved insulin sensitivity. The study suggests a new means to potentially treat Type 2 diabetes and nonalcoholic fatty liver disease by lowering ceramide levels, which interfere with insulin signaling.
A new study led by McMaster University professor Dr. Deborah Cook found that a program honoring patients' last wishes creates meaning, memories, and closure at death. The Three Wishes Project, which involved 40 dying patients and their families, resulted in the implementation of 97.5% of requested wishes.
While some IRB members still feel pressure to approve protocols with biases, significant progress has been made in disclosing and managing conflicts of interest since 2005. The study suggests that formal written definitions of conflict of interests have improved, but more work is needed.
The latest Ebola outbreak is the largest, most sustained, and most widespread to date, with several potential treatments undergoing clinical trials. Dr. Ali Mirazimi notes that emerging infectious diseases will continue to challenge global health.
Researchers found that coronary artery calcification scans can accurately predict all-cause mortality up to 15 years in asymptomatic patients. The study's findings suggest that CAC scanning could help physicians identify patients at risk for early death and advise them to adopt healthier lifestyles.
A meta-analysis of 12 randomized controlled trials found that vegetarian diets lead to significant weight loss, with vegan diets showing the greatest results, and benefits attributed to high intake of whole grains, fruits, and vegetables.
A national survey found that patients are interested in using email and Facebook to manage their health, but few actually do so. Only 7% of respondents use their physicians' websites to access their own health information, highlighting a disconnect between patient interest and current institutional practices.
A new article highlights key action areas for healthcare professionals to improve the quality of life of older adults by maintaining brain health. Action areas include formal cognitive assessments, screening for risk factors, and promoting physical exercise and social engagement.
Researchers found that state policies on organ donation and transplantation had virtually no effect on rates of organ donation and transplantation in the US. Only revenue policies, which allow individuals to contribute to protected state funds for donation promotion activities, were associated with a 5.3% increase in transplants.
ER revisit rates exceed expectations, with one in five patients returning within 30 days and one in 12 after three days. Total cost of revisits is higher than initial visits, highlighting the need to understand what leads to these repeated visits.
A systematic review of published evidence found that extended dual antiplatelet therapy (DAPT) decreases the risk for myocardial infarction but increases major bleeding events and may increase mortality. The authors suggest based on patient preferences after discussing benefits and harms.
A case report suggests that taking an unlabeled stimulant like BMPEA in a sports supplement combined with exercise can cause a hemorrhagic stroke. The patient reported sudden numbness and clumsiness after exercising, highlighting the potential risks of untested stimulants in dietary supplements.
A study found that nondisclosure agreements in medical malpractice settlements are often used with little standardization or consistency, selectively binding patients and making them hard to justify on privacy grounds. The use of these agreements may be subject to review and could potentially restrict reporting to regulatory bodies.
A disease-specific employee-based health plan can improve medication adherence by almost five percent, translating to a one percent reduction in healthcare spending. The plan also reduces hospital visits and emergency treatment centers.
A new detailed guide provides advice on urinary catheter use, suggesting that far fewer hospital patients should receive them. The Ann Arbor Criteria recommend using catheters only in certain situations, such as for intensive care unit patients who need hourly urine volume measurement.
Researchers identified mutations in PARN and RTEL1 genes, which cause excessive telomere shortening and lung scarring disease. The findings strengthen the link between lung fibrosis and telomere dysfunction.
The American College of Physicians (ACP) has released best practice advice for cervical cancer screening, supported by ACOG and ASCP. The guidance aims to reduce overuse of screening in average-risk women without symptoms.
Dr. Philipp Scherer, Director of UT Southwestern's Touchstone Center for Diabetes Research, receives the prestigious Banting Medal for his significant contributions to understanding and treating diabetes. His research focuses on adipocytes and has demonstrated an initially protective role for obesity in regulating metabolism.
The USPSTF completed a systematic evidence review to inform an upcoming update of Task Force recommendations on screening asymptomatic adults for type 2 diabetes. Screening was found to help delay progression to diabetes by identifying those who could benefit from treatment, but did not improve mortality rates.
A retrospective cohort study of nearly 217,000 patients with gout found that prescription rates for effective gout treatment decreased after the FDA increased prices. The study also showed significant increases in monthly total prescription bills, highlighting the negative impact of regulatory actions on access to affordable medications.
Researchers found that Weight Watchers and Jenny Craig are the most effective commercial weight-loss programs for long-term weight loss. In contrast, physical therapy was as effective as surgery in alleviating symptoms of lumber spinal stenosis. Leading internists also advocate for a more thoughtful approach to cardiopulmonary resuscit...
Researchers analyzed data from over 8,399 participants and found that daily apple eaters had higher odds of avoiding prescription medications. However, the study did not find a significant association between apple consumption and reduced healthcare use.
The US Preventive Services Task Force finds that routine screening for thyroid dysfunction in nonpregnant, asymptomatic adults lacks sufficient evidence. In contrast, the American Diabetes Association recommends individualized treatment plans for patients with diabetes, taking into account factors like age, comorbid conditions, and car...
A national survey found that one in three older Americans experience age-related discrimination, leading to new or worsened functional ailments. Healthcare providers can reduce this effect by treating patients with respect and dignity, regardless of age or socioeconomic status.
A study from the Cornell Food & Brand Lab found that movie-goers watching tearjerkers ate 28-55% more popcorn during the Thanksgiving holiday. This increased consumption was attributed to emotional eating triggered by sad movies.
The American College of Physicians has released new guidelines for preventing and treating bedsores, recommending protein supplementation and hydrocolloid dressings to reduce wound size. Advanced static mattresses and overlays are also recommended for patients at increased risk, while alternating air mattresses and overlays are advised...
Men who used saunas frequently had reduced risks of fatal cardiovascular events and all-cause mortality. The risk was particularly lower for those using the sauna 2-3 times per week, with significant reductions in cardiovascular disease and death rates observed.
A study found that watching a video explaining CPR and intubation procedures improved patient understanding, with 72% opting against intubation and 64% refusing CPR. Videos helped patients express their choices to doctors, promoting patient-centered care.
Researchers found a simple fiber-rich diet to be nearly as effective as the American Heart Association (AHA) diet for weight loss and improving metabolic health. However, AHA diet's many rules may make adherence challenging for some. Meanwhile, clinical risk calculators seriously overestimate heart attack risk. Sore throats in young ad...