Articles tagged with Internal Medicine
Less than 15% of internal medicine residency programs have a formal curriculum addressing cost-conscious care, despite a national consensus on the issue. The study found that western US programs and university-based programs were more likely to adopt such curricula.
Most multivitamin supplements have no benefit in preventing chronic disease or death, and long-term use does not preserve cognitive function. Researchers found that high doses of multivitamins and minerals do not protect against cardiovascular events following myocardial infarction.
A recent study found that over 18% of lung cancers detected by low-dose computed tomography (LDCT) may be cases of overdiagnosis, where the cancer would not have become clinically apparent without screening. This could lead to unnecessary treatment, anxiety, and increased healthcare costs.
A study published in JAMA found that simulation-based communication skills training had no effect on the quality of end-of-life care, but was associated with a small increase in patients' symptoms of depression. The researchers suggest that skills transfer from simulation training to actual patient care may be inadequate.
The American College of Physicians recommends that individuals with heart disease should only receive red blood cell transfusions if they have severe anemia. Additionally, researchers found that the concept of 'healthy and overweight' is a myth, as individuals in the same BMI category can have varied metabolic features. The study's fin...
The American College of Physicians recommends restricting red blood cell transfusions to severe anemia cases in patients with heart disease. ACP also advises against using erythropoiesis-stimulating agents in mild to moderate anemia with heart conditions due to increased risks of thromboembolic events and stroke rates.
A review of President John F. Kennedy's medical records reveals a complex medical history, including Addison's disease and hypothyroidism. Researchers now believe Kennedy may have had polyendocrine syndrome type II, a rare autoimmune disorder combining the two conditions.
A new study published in Annals of Internal Medicine suggests that calculating comorbidity-adjusted life expectancy may help physicians determine whether to continue or stop cancer screening in elderly patients. The researchers found that patients with higher levels of comorbidity had shorter life expectancies than healthy patients of ...
Researchers at the University of Iowa found that maintaining a direct channel of communication between patients and primary doctors is crucial to success. Patients in regular contact with their primary physicians are most satisfied with their care, according to a new study.
A recent study published in Annals of Internal Medicine found that women who adhered to a Mediterranean-type diet in midlife had greater physical and mental function in old age. Researchers also developed a scoring system to identify low-risk patients for strep throat, which could potentially save hundreds of thousands of doctor visits...
The American College of Physicians (ACP) recommends against routine screening for chronic kidney disease (CKD) in asymptomatic adults, citing the potential harms of testing. ACP also advises against treating patients with stage 1-3 CKD with combination therapy, due to increased risk of adverse effects.
The USPSTF found no conclusive evidence to support routine blood pressure screening in asymptomatic youth. However, there is a growing concern about the increasing rates of childhood obesity and its potential impact on adult cardiovascular health.
The American College of Physicians outlines a team-based model of healthcare with 13 principles to encourage effective teamwork and collaboration. Highly-functioning teams assign responsibility based on patient needs, prioritize culture, communication, and mutual respect.
A new study reveals that American doctors are more likely to experience burnout, depression, and lower satisfaction with their quality of life due to long working hours and personal responsibilities. The study found that physicians who work in academic medical centers, are younger, or female are particularly affected.
A study published in JAMA Internal Medicine found that women with acute coronary syndromes are more likely to present without chest pain, despite it being the most common symptom for both sexes. The study also showed that women without chest pain had fewer symptoms overall compared to those with chest pain.
A recent study published in JAMA Internal Medicine found that critically ill patients often receive futile treatment, with estimated costs of $2.6 million over three months. The most common reason for perceiving treatment as futile was the significant burden it placed on the patient's quality of life.
A UCLA/USC study finds that a patient-centered model with round-the-clock access and coordinated care improves patient satisfaction to 65% and physician satisfaction to 51%. The Galaxy Health program also shows promise for encouraging more medical school graduates to enter primary care.
The USPSTF recommends that primary care clinicians provide education or brief counseling to prevent tobacco use in school-aged children and adolescents. A systematic evidence review found that such interventions can reduce the risk of smoking initiation by 19% compared to control participants.
Researchers found that generic substitutions result in $127-$160 annual savings, while therapeutic substitutions yield $389-$452 per beneficiary. Therapeutic substitutions have the potential to double or triple annual cost savings compared to generic substitutions.
The Gerontological Society of America has awarded Richard M. Allman, MD, with the 2013 Joseph T. Freeman Award for his contributions to geriatric research and practice. The award recognizes his focus on understanding mobility loss in older adults and improving age-related health disparities.
The UT Southwestern Geriatrics section has received a $1 million four-year grant from the Donald W. Reynolds Foundation to enhance interprofessional education and patient safety. The grant will support a curriculum that incorporates virtual and face-to-face experiences, as well as faculty development and training.
Screening asymptomatic high-risk adults for lung cancer using low-dose computed tomography (LDCT) may significantly reduce mortality, according to a systematic review. The US Preventive Services Task Force reviewed 67 articles and found that LDCT screening can detect lung cancer at an earlier stage, leading to lower mortality rates.
A study found that strong doctor-patient relationships facilitate conversations about healthcare costs, particularly when patients feel trust their physician. Patients are more willing to discuss personal out-of-pocket costs than insurer costs, and older and sicker individuals are more receptive to discussing costs.
A recent study by Yale University researchers found that former prisoners are more likely to be hospitalized for acute preventable conditions, with a rate 30-65% higher than the general population. The study's results highlight the need for improved healthcare before and after release.
Two independent reviews of rhBMP-2 trial data found no significant benefits and potential increased risks of cancer associated with its use. The studies suggest that patients should be counseled on the relative benefits and harms of each option, as the role of rhBMP-2 in spinal surgery is still being defined.
A Yale project has made all of Medtronic's clinical trial research data for a bone growth product available for independent reanalysis. The project, known as the Yale University Open Data Access Project (YODA), aims to address the problem of unpublished and selectively published clinical evidence.
A study of over 70,000 Seventh-day Adventists found that vegetarian diets were associated with a 12% lower risk of death. Men showed significant reductions in cardiovascular disease mortality and ischemic heart disease deaths compared to non-vegetarian diets.
A survey of 22,000 patients found that those who preferred to participate in medical decisions had a 0.26-day longer length of stay and $865 higher total hospitalization costs. Patient preference increased with educational level and private health insurance.
Phyllis Guze, M.D., associate vice chancellor at UCR Medical School, has been awarded the Dema C. Daley Founder's award by APDIM for her career dedication to exemplary teaching and innovative educational program management. She also received the Mastership designation from ACP, recognizing her contributions to medicine and medical educ...
A new study by Johns Hopkins Medicine found that medical interns spend an average of only 12 percent of their time at the bedside, with nearly as much time spent walking and caring for patients. The researchers argue that this amount of time is insufficient to provide optimal patient care and learning opportunities.
The American College of Physicians (ACP) has introduced two evidence-based interventions and two videos to enhance patient-clinician communication in the first year following an acute coronary syndrome (ACS) event. The initiatives aim to improve health outcomes by providing a patient guide, clinician support tool, and video resources.
Annals of Internal Medicine and ACP honor Adrienne Allen, MD, MPH, and Matthew Spitzer, MD, for their groundbreaking research on patient safety and erectile dysfunction. The awards highlight the importance of rigorous methodology and potential impact on clinical practice.
The ACP Clinical Guidelines app provides clinicians with easy access to evidence-based clinical recommendations and rationale, saving them time in their practice. Available on iPhone, iPad, and Android, the app includes guidance statements and high-value care advice for all currently active guidelines.
A new study by the University of Michigan found that Michigan hospitals have significantly lower rates of catheter-associated urinary tract infections (UTIs) compared to other US hospitals. The study, which used a low-tech approach to timely removal of urinary catheters, resulted in a 25% decrease in UTI rates at Michigan hospitals.
A study found significant variation in vena cava filter use among California hospitals, with some hospitals using them up to 38.96% of the time. Hospital characteristics such as small bed count, rural location, and private status were associated with increased VCF use.
A clinical trial found that a centralized, patient-preference program decreased depressive symptoms and may be cost-neutral over time. Active treatment for post-ACS depression was associated with significant improvements in symptoms and potentially lower healthcare costs.
The AHRQ report identifies 10 strongly recommended patient safety strategies, including preoperative checklists and hand hygiene, to prevent harmful events in US healthcare institutions. The report builds on previous research and provides clinicians with a sound basis for integrating proven strategies into their care.
A significant majority of uninsured and underinsured patients use email and text messaging in their everyday lives, but many clinics do not offer patient portals or secure messaging. Patients are interested in using electronic communication with providers, which could improve clinical communication and efficiency.
A new study from Karolinska Institutet reveals that cortisone increases the risk of acute pancreatitis. Patients treated with cortisone are recommended to avoid alcohol and smoking to minimize the risk. The study found a 70% higher risk of developing acute pancreatitis among those taking cortisone tablet form.
A study found that 40% of top-ranked and 36% of non-top-ranked hospitals struggled to provide a price estimate for total hip replacement, with costs ranging from $11,100 to $125,798. The researchers suggest consumers should ask for cost information and be persistent in obtaining it.
Public health experts at Johns Hopkins Center for Gun Policy and Research emphasize the need for evidence-based policies to prevent gun violence. Physicians are urged to engage in prevention efforts through strategies such as discussing guns with patients and advocating for change in Congress.
A study published in JAMA Internal Medicine found that men's decisions to undergo prostate-specific antigen (PSA) screening are influenced by how information is presented. The researchers discovered that men who were given a balance sheet with relevant features of PSA screening were more likely to choose the screening option, while tho...
The ACIP has updated its recommended 2013 adult immunization schedule to include new guidelines for the use of pneumococcal conjugate and influenza vaccines. The updated schedule also recommends routine Tdap vaccination for adults aged 65 or older, pregnant women, and all patients over 6 months old against influenza.
A new study by Johns Hopkins Medicine found that hospitalists nationwide report daily patient loads frequently exceed safe levels, posing risks to patients' safety and quality of care. The study revealed that one in five physicians feels their workload puts patients at risk for serious complications.
A new study led by Wayne State University will aim to develop methods for better identifying women at increased risk for stroke. The research aims to educate doctors on how to follow recommended guidelines to identify these patients, leading to improved treatment and screening rates.
A new study found that doctors who are culturally aware provide better quality of care to HIV patients from ethnic minorities. These patients tend to manage their treatment and condition better and have improved health outcomes. Increasing healthcare provider cultural competence can reduce racial disparities in both the quality of care...
A recent study published in JAMA Internal Medicine found that higher spending on breast cancer screenings does not result in improved outcomes for older women. The research team analyzed Medicare expenditures and screened female beneficiaries over two years, discovering substantial geographic variation in costs.
A national survey found that over a third of US physicians fulfill patient requests for brand-name drugs, which are up to 80% more expensive than generics. Industry marketing relationships and personal connections with pharmaceutical companies also contribute to this practice.
A new study has developed a risk scoring system to identify hospitalized patients at high risk of gastrointestinal bleeds, allowing for targeted use of acid-suppressive medication. The study found that older adults, males, and those with liver disease or clotting disorders are most at risk, enabling clinicians to individualize treatment.
The JAMA Network has announced new titles for its specialty journals, including JAMA Pediatrics, JAMA Neurology, and JAMA Internal Medicine. Starting January 1, 2013, these journals will have a new embargo schedule, with content available on the For the Media site at specific times.
Barbara Gilchrest, a renowned dermatologist at Boston University School of Medicine, has been elected as a 2012 Charter Fellow of the National Academy of Inventors. She is being honored for her prolific spirit of innovation in creating outstanding inventions that have improved quality of life and economic development.
A recent study published in Nature Medicine identified a key protein called mitoNEET that plays a crucial role in fat cell metabolism. Elevated levels of this protein were found to expand fat tissue without leading to obesity-related health issues, such as type 2 diabetes.
A new study by Scott Wright and Joseph A. Carrese examines ethical dilemmas for physicians when patients make financial donations to medical institutions. The researchers found that doctors are concerned about the potential impact on their relationships with patients and the purity of the doctor-patient bond.
A study published in JAMA found that only 21.5% of graduating medical residents reported a career plan in general internal medicine. The majority (65.3%) opted for subspecialty careers. Gender and nationality differences were observed, with women more likely to pursue generalist careers.
The American College of Physicians releases new clinical practice guidelines for stable ischemic heart disease, emphasizing patient education and risk factor modification. The guidelines address initial cardiac testing, management, and follow-up care for patients with stable IHD.
The American College of Physicians (ACP) suggests using evidence-based performance measures to assess the use of low-value interventions, such as routine X-ray or advanced imaging methods for uncomplicated low back pain. This approach aims to improve health care quality by changing clinician behavior through feedback and public reporting.
A study published in Archives of Internal Medicine finds that per capita Medicare spending on the elderly has grown nearly three times faster in the US than in Canada since 1980. The authors attribute this difference to Canada's single-payer system, which includes fewer administrative costs and a greater emphasis on primary care.
A physician warns of the dangers of fungal meningitis due to contaminated injectable corticosteroids, emphasizing the importance of sterility in compounding processes. The author advocates for a case-by-case approach to treatment and calls for increased regulation to prevent future outbreaks.
A study by Lisa Kern and her team found that electronic health records (EHRs) are associated with higher quality ambulatory care in primary care physicians. The researchers compared the performance of physicians using either EHRs or paper records, assessing nine specific quality measures for a total of 466 primary care physicians.
The IU and Regenstrief clinician-researchers will work with 19 central Indiana nursing facilities to improve the quality of care, reduce hospitalizations, and increase access to palliative care for long-stay residents. The comprehensive four-year initiative, OPTIMISTIC, aims to transform institutional care and address the neglected nee...