Articles tagged with Internal Medicine
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...
The Strategic Pharma-Academic Research Consortium (SPARC) has awarded over $1.9 million to advance research on autoimmune diseases such as multiple sclerosis, lupus, and Crohn's disease. The funded projects will focus on understanding the root causes of these conditions and developing new treatments.
A new report from the Institute of Medicine proposes revised diagnostic criteria for chronic fatigue syndrome, highlighting its physiologic nature. The criteria also emphasize the debilitating symptom of post-exertional malaise, where exertion triggers prolonged periods of fatigue.
A study found that only 4% of published clinical trials mentioned FDA inspection violations, despite 74% having protocol violations. The FDA's lack of transparency and notification to journals contributes to this issue, making it difficult to track research misconduct.
A study found that an oral supplement containing arginine, zinc, and antioxidants improves healing of mild to severe pressure ulcers in malnourished patients. Meanwhile, a survey suggests that pain and other alarming symptoms in the last year of life have increased from 1998 to 2010. The Centers for Disease Control and Prevention's ACI...
The American College of Physicians marks its centennial year with a focus on the role of internal medicine in healthcare systems, professional satisfaction, and cost control. The journal also explores the challenges of sharing clinical trial data, highlighting the need for a consistent approach to balance benefits and risks.
A recent study published in JAMA Internal Medicine found that low-risk patients presenting to the emergency department (ED) with chest pain did not experience a significant increase in heart attack risk regardless of the initial diagnostic testing strategy. The researchers analyzed data from over 421,000 ED visits and concluded that ce...
A systematic review found that prolonged sitting is independently associated with negative health outcomes and mortality, especially among those who exercise little. Tips from the author include taking regular breaks to stand or move around, setting achievable goals for reducing sedentary time.
A large study found a strong association between eating more whole grains and lower total and cardiovascular mortality rates. The researchers estimated that every serving of whole grains per day was associated with a 5% lower total mortality rate or a 9% lower CVD mortality rate.
Medical ethicists offer guidance on life-sustaining therapies for Ebola patients in developed countries, balancing risks and benefits. Former Surgeon General David Satcher discusses the importance of credibility and influence in the role, emphasizing scientific evidence-based reports.
A systematic review published in Annals of Internal Medicine suggests that blood pressure-lowering therapy can reduce stroke, cardiovascular deaths, and total deaths in patients with mild hypertension. Ambulatory monitoring may also improve the diagnostic accuracy of office screening for high blood pressure.
Nonfatal indoor tanning-related injuries treated in US hospitals averaged 3,234 annually between 2003-2012. Most common types were skin burns, syncope, and eye injuries.
Researchers found that black patients' poorer health at diagnosis, not treatment differences, explains most of the racial disparity in colon cancer survival. Emphysema detected on CT scans is linked to increased mortality among those without airflow obstruction or COPD.
Research shows that patients receiving basic life support (BLS) have greater survival to hospital discharge and 90-day post-discharge compared to those receiving advanced life support (ALS). BLS providers tend to spend less time at the scene, leading to higher mortality rates in ALS patients.
The US Preventive Services Task Force concludes that current evidence is insufficient to assess the benefits and harms of routine screening for vitamin D deficiency. Researchers found no direct evidence on the effects of screening versus no screening, but treating patients with low serum levels may help prevent adverse outcomes.
A study found that programming electronic health records to make generic drugs the default choice increases generic medication prescribing rates, leading to cost savings and reduced healthcare spending. The intervention was effective in both ambulatory clinics and did not require additional effort from physicians.
A McGill University Health Centre study found that adopting structured antibiotic time-outs led to decreased antibiotic costs and a small decline in Clostridium difficile infections. The time-out program, which involved regular re-evaluation of treatment strategies, resulted in improved prescribing practices among physicians.
A study finds that elderly Americans with low health literacy are less likely to use the internet for health information. Interventions targeting health literacy among older adults may help bridge the digital divide.
A new study found that survivors of heart attacks and strokes experience a rapid decline in physical abilities over time, leading to increased disability and depressive symptoms. The study suggests that these survivors should be screened for functional disability long after discharge from the hospital.
The American College of Physicians recommends a systematic approach to discussing end-of-life care goals with patients, aiming for better quality of life and longer survival rates. The guidelines also highlight the importance of training clinicians, identifying at-risk patients, and using structured communication formats.
A survey of 409 physicians found that many are unaware of the latest treatments and guidelines for allergic conditions. The study highlights the importance of seeking a board-certified allergist for accurate diagnosis and treatment.
Only one in two young adults with hypertension receive lifestyle education to lower their blood pressure. A study found that exercise and quitting smoking were the most common topics addressed.
A Medicare beneficiary study suggests dabigatran may be associated with a higher incidence of major bleeding compared to warfarin. Dabigatran was also found to have a higher risk of gastrointestinal bleeding but lower risk of intracranial hemorrhage than warfarin.
A national study found that prescription opioids were involved in 67.8% of opioid overdoses in emergency departments, while heroin accounted for 16.1%. The study also highlighted the importance of healthcare providers prescribing opioids with caution to patients with pre-existing conditions.
Researchers developed a random transmission model to determine how disease progression and case fatality affect transmission and patient isolation. Isolating the sickest Ebola-infected individuals before they progress into their late phase of illness can effectively eliminate the Ebola epidemic in Liberia.
A new study by Yale University researchers found that buprenorphine maintenance therapy is more effective than detoxification in treating patients with prescription opioid dependence. Patients who received ongoing buprenorphine were less likely to use illicit opiates and had better treatment outcomes.
A new study by the University of Michigan found that one in five physicians was unaware a patient had a central venous catheter, which can lead to life-threatening complications such as bloodstream infections and blood clots. The study suggests that improving device awareness is crucial for preventing these complications.
Researchers developed the 3D-CAM test, a short and structured diagnostic assessment to diagnose delirium. The test was highly sensitive and specific, with a sensitivity rate of 96% and specificity rate of 98%. Additionally, a study found that clinicians often remain unaware of patients' central venous catheters in place, posing a patie...
Experts warn conventional US medical centers may struggle to manage Ebola due to lack of preparedness and training. Regional referral centers could help address the shortage of high-level biocontainment patient facilities.
A commentary cautions against using experimental Ebola drugs without proper triage to minimize risks. Meanwhile, health economists highlight a major flaw in the FDA's cost-benefit analysis of proposed cigarette labeling regulations. Additionally, a national study reveals that medical residents have varying levels of knowledge on High V...
A study published in Annals of Internal Medicine found that medical residents' knowledge of High Value Care is essential for patient outcomes. The study used the IM-ITE exam and a hospital care intensity index to assess resident knowledge, revealing that conservatively managing patients was a key competency.
Researchers at UCSF found a nurse-led intervention program did not improve 30-day hospital readmission rates among ethnically and linguistically diverse older patients. The study suggests hospitals evaluate such programs before implementing or continuing.
A recent study published in the Journal of General Internal Medicine found that healthy Americans who undergo colonoscopies do so too frequently, with many receiving repeat screenings long before they should. The study suggests that endoscopists should adhere to national guidelines more closely.
Researchers at UT Southwestern Medical Center discovered that acetate supplements stimulate the formation of new red blood cells in mice with anemia. This could lead to alternative treatments for anemia, potentially reducing side effects associated with current therapies.
Commentaries in Annals of Internal Medicine argue that Proposition 46's mandatory physician drug testing could deter help-seeking and reporting, potentially harming patients. The authors instead advocate for addressing physician impairment through more nuanced solutions.
The USPSTF recommends intensive behavioral counseling to reduce risky sexual behaviors among all sexually active adolescents and adults at risk for STIs. Chlamydia and gonorrhea screening is recommended for young women under 24 and older women at increased risk, including pregnant women.
A recent study found that sickle cell patients who experience discrimination are 53% more likely to not adhere to their doctors' orders. The researchers analyzed the experiences of 291 patients with sickle cell disease and found a significant association between perceived discrimination and non-adherence.
The American College of Physicians (ACP) advises pregnant women at high risk for preeclampsia to take daily low-dose aspirin. Meanwhile, a study found that health insurance remains unaffordable for many younger adults under the Affordable Care Act, with premiums often exceeding the cost of purchasing a plan.
A new study found that residency training in locations with less intensive practice patterns is associated with better clinical decision-making. Physicians trained in these environments consistently scored higher on a management exam subscale, indicating their ability to make conservative decisions without sacrificing patient outcomes.
Two commentaries in Annals of Internal Medicine emphasize the need for immediate Ebola vaccine deployment and cautious approach to containment plans. The authors argue that safety risks from vaccines are negligible compared to healthcare worker risks, while excessive measures can foster mistrust and increase risk.