Articles tagged with Internal Medicine
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...
A new over-the-counter HIV test, OraQuick, is unlikely to significantly impact the fight against HIV due to its high cost and limited accessibility. Physicians recommend counseling patients about the use and limitations of home testing to make informed decisions.
A nationwide study found that primary-care physicians earn an average of $2.8 million less than their specialist colleagues over a lifetime, potentially discouraging medical students from pursuing primary care. The study's authors recommend reducing pay disparities to ensure adequate access to primary care.
Researchers found that brief, multicontact behavioral counseling interventions delivered by primary care physicians reduced hospital stays for adults with risky drinking. The campaign 'Tips from Former Smokers' successfully encouraged smokers to quit, with calls to the toll-free quit line more than doubling during the 12-week campaign.
A new Case Report highlights the dangers of fake antimalarial medicines sold worldwide, particularly in Equatorial Guinea. The drugs were confirmed to be counterfeit despite convincing packaging, underscoring the need for traveller vigilance.
Hospital-initiated transitional care strategies reduce unnecessary health services use and improve patient outcomes for adults with acute stroke or myocardial infarction. Electronic record use, medication reconciliation, and shared follow-up planning also enhance patient transition from hospital to primary care.
Researchers found that midlife fitness levels can lower the onset of chronic diseases such as congestive heart failure, Alzheimer's disease, and colon cancer decades later. Fitter individuals aged well with fewer chronic illnesses to impact their quality of life.
New CDC guidelines recommend universal HCV screening for all Americans born between 1945 and 1965, with strong evidence supporting the association between sustained virologic response and reduced liver cancer risk. Brief alcohol screening and intervention are also recommended for those diagnosed with HCV.
A recent study by Johns Hopkins researchers reveals that being underinsured is a strong predictor of death among patients admitted to hospital with serious cardiac events. The study found that underinsured patients had a higher risk of early death compared to those with private insurance, regardless of their racial background.
Researchers discover tick bites trigger alpha-gal antibodies in patients, leading to delayed anaphylaxis after eating red meat. The study highlights a previously unknown food-induced severe allergic reaction due to a carbohydrate, not protein.
The NYC trans fat ban resulted in a significant reduction of trans fat consumption among fast food patrons, with a notable decrease in saturated fat intake. Young women who have never been pregnant are also at risk for urinary incontinence, affecting up to 12.6% of those surveyed. Prophylactic antidepressant therapy may help prevent tr...
A study reviewed medical literature on cranberry products and found a reduced risk of urinary tract infections in individuals who consume these products regularly. The study suggests that cranberry-containing products may be effective in preventing UTIs in specific groups, such as women with recurrent UTIs and children.
The American College of Physicians developed a free curriculum to train internal medicine residents in identifying and eliminating wasteful treatment options. The high-value, cost-conscious care curriculum focuses on patient cases requiring careful analysis of benefits, harms, costs, and evidence-based decision making.
The US Preventive Services Task Force recommends that clinicians screen all adult patients for obesity and offer intensive behavioral interventions. While medium- to high-intensity counseling produced small short-term improvements in cardiovascular health, the task force concludes that these interventions are more effective when delive...
An international study found living alone associated with increased four-year mortality and cardiovascular death among stable outpatients at risk of or with arterial vascular disease. The risk was highest among middle-aged individuals, suggesting that social isolation may be a significant contributor to cardiovascular risk.
A survey of resident physicians reveals that more than half had worked with flu-like symptoms, citing responsibility to colleagues and patients as top reasons. Female residents were more likely to work sick, fearing being perceived as weak. The study calls for better identification and address of presenteeism by medical educators.
L. Barth Reller, a renowned clinical microbiologist, has been recognized with the 2012 TREK Diagnostic ABMM/ABMLI Professional Recognition Award for his outstanding contributions to the field. He is also an accomplished mentor and trainer of medical microbiologists, having mentored 38 fellows who now hold leadership positions globally.
A new study suggests that some physicians would recommend colorectal cancer screening for 80-year-old patients with advanced lung cancer who would not benefit from the procedure. Physicians were found to be more likely to recommend invasive tests like colonoscopy rather than non-invasive ones.
Three US Army medical residents received national awards for their research at the American College of Physicians annual meeting. The ACP's Internal Medicine meeting provides a valuable opportunity for military and civilian physicians to collaborate and share best practices.
Two US Army physicians, Col. Gregory J. Argyros and Alan J. Magill, were inducted as Masters in the American College of Physicians for their contributions to internal medicine through teaching, research, and medical practice. The honors recognize the Army's commitment to board certification, continuing education, and exceptional patien...
A recent study published in Nature Communications has identified a key component regulating pulmonary fibrosis, a fatal disease with currently no cure. The researchers found that the CLYD gene serves as a crucial negative regulator, halting disease progression and potentially opening new avenues for treatment.
A systematic review of 94 trials found that drugs are effective in achieving continence and improving quality of life, but with small improvements and frequent side effect discontinuation. Fesoterodine was more effective than tolterodine, while solifenacin showed the lowest rates of treatment discontinuation due to adverse effects.
A study of 1018 adults found that those who consumed chocolate more frequently had a lower body mass index (BMI) compared to those who ate it less often. The researchers also found a positive association between chocolate consumption and improved metabolic health, including lower blood pressure and insulin sensitivity.
The USPSTF recommends a three-year Pap smear schedule for women aged 21-65, allowing those over 30 to go five years between tests if they undergo HPV screening. Women under 21 and older than 65 are not recommended for routine screening.
Providing personal mobile computers to medical residents increases their efficiency and enhances continuity of care. The study found that residents submitted 5% more orders before morning rounds and 8% more orders before handing off responsibilities.
A study found that family members of ICU patients tend to be overly optimistic about recovery prospects, even when faced with poor prognoses. The researchers suggest that this optimism serves as a coping mechanism in high-stress situations, and may lead to caregiver decisions that do not reflect the patient's values.
Researchers discovered that eliminating a specific protein called FoxO1 protects the heart from stress caused by diabetes. This finding could lead to new treatments for patients with diabetes.
A study found that patients leaving hospitals against medical advice do not have to pay the full cost of their stay, as insurance companies typically cover the expenses. However, many physicians and some consent forms incorrectly inform patients that they may be held financially responsible if they leave AMA.
A new study found that daily diet soft drink consumption may be associated with a higher risk of vascular events, including stroke and heart attack. In contrast, regular soft drink consumption and moderate intake of diet soft drinks do not appear to increase the risk of these events.
A new study finds that physician referral rates in the United States increased by 92% over a decade, leading to an estimated 159% increase in visits resulting in referrals. This surge in referrals is attributed to increased specialization and the increasing responsibilities of primary care physicians.
UT Southwestern researchers found that exercise stimulates autophagy, a process that degrades damaged cellular components. This discovery suggests that autophagy plays a crucial role in the protective effects of exercise on blood sugar metabolism and may contribute to other health benefits.
A Yale University study found that factors like chronic conditions, low physical activity, and hospitalization increase the likelihood of elderly disability. Women are also more likely to become disabled in later years.
A new study by Yale researchers found that measuring patient deaths over a 30-day period, rather than just during initial hospitalization, provides a more accurate assessment of hospital quality. This approach reveals significant differences in quality between hospitals and favors those with shorter patient stays.
A recent survey of doctors and patients found contrasting opinions on electronic records, with PCPs worried about increased demands and patient confusion, but patients expressing enthusiasm for sharing notes. Meanwhile, the US Preventive Services Task Force reviewed evidence on vitamin D supplementation for fracture protection and canc...
Inaccurate blood pressure measurements from faulty techniques result in misclassified patients and potentially different treatment decisions. A study published by the University of New Mexico found that 93% of patients have different blood pressure readings when using outdated versus updated guidelines.
A nationwide survey found that few hospitals are aggressively combating catheter-associated urinary tract infections, a common healthcare-associated infection. The study suggests that hospitals may not be using enough prevention practices for UTIs, despite increased use of methods to prevent other hospital-acquired infections.
Patients on liver transplant waiting lists prefer to receive high-quality donor organs, even if it means waiting longer, according to a new study. The research found that 58% of candidates would only accept organs with a risk of graft failure of 25% or less.
Researchers developed a blood test that measures lung protein levels to quantify smoking-related effects on heart disease. Smokers with high lung protein levels are more likely to develop dangerous plaque buildup in blood vessels.
Inadequate handovers during patient care shifts lead to decreased continuity of care and higher risk of adverse events. Effective strategies, such as prioritizing acutely ill patients and minimizing discussion on straightforward cases, can improve the quality of sign-out processes.
A new testing program coupled with a year-long clinical experience improved internal medicine resident scores on the Internal Medicine In-Training Exam. The study found that residents who participated in the program showed a significant increase in median individual percentile rank, outperforming control groups by 8.5 percentile points.
Researchers at Mount Sinai School of Medicine found that $6.7 billion was spent on unnecessary tests or medications, with brand-name statins accounting for 86% of the cost. Excess spending included blood work, bone density scans, and antibiotic prescriptions.
A survey of US primary care physicians reveals that nearly half believe their patients receive too much medical care, while 52% think the amount is just right. The authors suggest that reimbursement systems should encourage longer visits to reduce pressures on physicians.
A study of over 1,100 women found hip fractures increase short-term mortality rates for women aged 65-79 and those aged 80+, even after controlling for underlying health status. Healthy women in this age group are at increased risk of death after a hip fracture.
A study suggests that referral practices need to be tailored by specialty. Primary care physicians are more likely to cite patient access and physician communication as reasons, while specialists prioritize patient experience.
A new study by Harvard Medical School researchers found that most uninsured patients in Massachusetts are employed but unable to afford employer-sponsored insurance or subsidized state plans. The study suggests that the system of coverage failed those who lost their job, particularly during economic downturns.
The American College of Physicians advocates for a seventh ACGME/ABMS general competency on cost-conscious care. Meanwhile, research on Bisphenol A (BPA) exposure in relation to diabetes remains inconclusive. Additionally, local incidence data may improve the diagnosis of strep throat, which affects millions worldwide each year.
A recent Mayo Clinic study found that 51.5% of US internal medicine residents reported burnout symptoms, with those owing over $200,000 in debt experiencing lower quality of life and test scores. The study also revealed a link between resident distress and lower-quality patient care.