Articles tagged with Internal Medicine
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.
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.
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 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 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.
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.
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.
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.
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...