Articles tagged with Internal Medicine
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 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.
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...
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.
Two American missionaries who contracted Ebola virus in West Africa deserve special treatment for their selfless act of caring for infected patients. The author argues that limiting experimental treatment to these two patients is necessary due to the ethical concerns of exploiting vulnerable individuals during a public health outbreak.
A comprehensive study in patients with type 2 diabetes found no evidence that blood pressure medication increases the risk of falling and breaking bones. In fact, results showed possible trends towards fewer fractures in intensive treatment groups.
A University of Michigan Medical School study reveals strategies for success in 'medical marriages', where one or both spouses are physicians. Key findings include the importance of mutual support, role definition, and shared values in maintaining a resilient relationship.
A commentary published in Annals of Internal Medicine reveals the history of 'miraculous' Ebola virus serotherapy, inspired by 19th century discoveries. Additionally, two systematic reviews address challenges of interpreting troponin levels in patients with chronic kidney disease.
The American College of Physicians recommends a full-night sleep study for patients with unexplained daytime sleepiness to diagnose obstructive sleep apnea. Obesity is the best documented risk factor for OSA, and symptoms include snoring, daytime sleepiness, and fatigue.
A study of over 4,100 New York State residents aged 60+ found that 2.7% were financially exploited in the past year, with 78% having their money or property stolen. Family members, particularly adult children, are the most common perpetrators.
A study found that early initiation of menopausal hormone therapy has a neutral effect on atherosclerosis progression in women. Meanwhile, the effectiveness of decision aids for advanced care planning is unclear due to limited research. Additionally, recent safety lapses at government labs pose a bioterror risk, highlighting the need f...
Researchers found that over-expression of Xbp1s in mice protected them against obesity and diabetes, with improved body weight, decreased blood glucose levels, and enhanced insulin sensitivity. The study suggests the brain controls glucose production by the liver, paving the way for new therapies to treat these conditions.
The US Preventive Services Task Force recommends against screening for asymptomatic carotid artery stenosis due to its high rate of false positives. A systematic review found no evidence that screening improves outcomes, but also identified a small risk of harms such as stroke and mortality.
New study finds sedentary behavior can be detrimental to cardiovascular health, independent of exercise. Researchers recommend taking short walks, tracking daily steps, and replacing desk chairs with fitness balls or treadmill desks.
A new study published in JAMA Internal Medicine shows that providing hospitalized patients with addiction treatment during their stay and upon discharge significantly reduces the likelihood of relapse. Buprenorphine, an opioid substitute, was found to curb withdrawal symptoms and lead to fewer days of illicit drug use.
The American College of Physicians recommends against routine pelvic exams for asymptomatic, average-risk women due to low diagnostic accuracy and potential harms. The guideline suggests that pelvic exams are appropriate only for women with symptoms or certain risk factors.
The US Preventive Services Task Force recommends annual screening for abdominal aortic aneurysms in men aged 65-75 who have ever smoked, while cautioning against widespread lung cancer screening among high-risk older adults due to insufficient evidence. The committee cited age-related risks and diminishing benefits of extended life fro...
The American College of Physicians recommends assessing a woman's health history for unique events that increase her risk of stroke later in life. For chronic hepatitis C patients, routine screening for liver cancer may not lead to greater survival.
A pilot study found that e-cigarettes are more acceptable and effective in helping smokers quit than nicotine inhalers. The devices' better marketing and high acceptance rates contribute to their popularity.
The updated 2014-2016 HHS Viral Hepatitis Action Plan aims to tackle rising incidences of liver disease and cancer caused by untreated chronic viral hepatitis. The plan builds on previous goals but expands evaluation metrics, calling for further commitments to decrease morbidity and mortality.
The American College of Physicians advocates for a patient- and family-centered approach to physician training, recognizing the value of partnerships between healthcare professionals and their loved ones. The organization's proposal includes establishing guidelines for active participation of patients and families in medical care.
The American College of Physicians recommends nine strategies to address societal barriers to reducing firearms-related violence. ACP advocates for approach firearm safety as a public health issue and supports universal criminal background checks to keep guns out of the hands of felons and others at risk.
Dr. Roger Unger has been awarded the 2014 Rolf Luft Award for his groundbreaking research on glucagon, which he identified as a key hormone balancing insulin regulation of blood sugar. His work revealed diabetes is a bihormonal disease with insufficiency of insulin and excess glucagon.
Researchers at UT Southwestern Medical Center have discovered a new pathway linking two major biological processes that occur after a heart attack, leading to potential cardioprotection. The study identifies the activation of the unfolded protein response (UPR) and the hexosamine biosynthetic pathway as key events in this process.
The USPSTF published its final recommendation statement on primary care interventions to prevent or reduce illicit drug and nonmedical pharmaceutical use in children and adolescents. Nearly one in 10 American adolescents use illegal drugs, with serious health consequences.
Most people who commit suicide receive regular healthcare services, yet a significant portion of these individuals are left with undiagnosed mental health conditions. Healthcare providers must become more attuned to patients' mental health states and possible suicide ideation to prevent suicides.
A study by the University of Wisconsin School of Medicine and Public Health found that young adults with hypertension are less likely to be prescribed antihypertensive medication, even when they have regular primary care visits. This delay can increase the risk of future cardiovascular events.
Aortic valve replacement improves symptoms but may not improve overall quality of life for high-risk patients. Researchers found rituximab to be ineffective in treating primary Sjögren's syndrome, while microsporidiosis should be considered in febrile transplant patients, especially those with unexplained illnesses.
The American College of Physicians and the Centers for Disease Control and Prevention have released an updated adult immunization schedule for 2014. Key changes include the removal of health care worker vaccination as an indication and updated recommendations for certain adults at increased risk for Haemophilus influenza type b (Hib) i...
A recent study by Group Health Research Institute found that patients with treated hypertension had 27-28% fewer specialty visits after implementing a patient-centered medical home. In contrast, clinically complex patients with multiple diseases saw a 3-5% increase in specialty use during the first two years after implementation.
A recent study published in the Journal of Investigative Medicine found that gastric banding patients often fail to meet daily nutrient requirements despite supplements and counseling. To maintain health after bariatric surgery, patients are advised to consume more protein-rich foods, include fatty fish, and limit processed foods.
The American College of Physicians has published new research on MERS, highlighting the need for better understanding and collaboration to combat its potential as a major public health threat. Guidelines for cholesterol treatment have also been released, sparking debate among physicians, while expert advice is offered on effective scre...
A study found that training hospital staff in basic hospice strategies led to improved end-of-life care, including more orders for pain medication and the removal of nasogastric tubes. The intervention also increased the presence of advance directives, reducing distress for patients and families.
A new study finds that FTM transgender patients have over 10 times higher odds of having an inadequate Papanicolaou (Pap) test compared to female patients. The researchers also found that FTM patients were more likely to have multiple inadequate Pap tests and had longer latency to follow-up testing.
A Mediterranean diet rich in extra-virgin olive oil reduces the risk of type 2 diabetes by up to 50% without calorie restriction, exercise, or weight loss. The study published in Annals of Internal Medicine suggests that a Mediterranean diet may have public health implications for diabetes prevention.
A recent study found that minority physicians care for 54% of minority patients and 70% of non-English-speaking patients. Minority physicians are also more likely to care for patients with lower self-reported health status. The study suggests expanding the racial diversity of the physician workforce could improve access to care.
The US Preventive Services Task Force recommends annual low-dose computed tomography (LDCT) screening for high-risk adults between 55 and 80 years old. Heavy smokers or former heavy smokers who have quit within the past 15 years are considered high risk due to increased lung cancer risk. The recommendation is based on comprehensive evi...
The article discusses the use of unlicensed vaccine Bexsero to combat meningitis outbreaks in the US, as well as new guidelines for BRCA mutation screening in high-risk women. The American College of Physicians also explains how Medicaid expansion will benefit poor citizens and their physicians by increasing access to healthcare.
A study found that preoperative medical consultation for cataract surgery became more common among Medicare patients, with significant variations in referral rates by patient age, race, and location. The research highlights an area of opportunity for reducing unnecessary healthcare resources.