Articles tagged with Internal Medicine
A study of 21 physicians found that patients often refuse medical recommendations for religious reasons, particularly in situations with moderate treatment benefits. Physicians should practice candid, respectful dialogue to negotiate accommodations with patients while respecting their differing worldviews.
A new analysis found that heavy alcohol drinking was associated with an increased risk of ischemic stroke in men. Moderate drinking of red wine, on the other hand, was linked to a lower risk of stroke compared to other forms of alcohol consumption.
Acupuncture was found to be effective in treating osteoarthritis of the knee, while its effectiveness for chronic neck pain was no better than placebo. A third study identified a clinical prediction rule that can predict which patients with low-back pain are most likely to benefit from spinal manipulation.
A study of 226 elderly adults with advanced cancer, congestive heart failure, or COPD found that virtually all participants experienced moderate to severe symptoms, including limited activity, fatigue, and physical discomfort. The study highlights the importance of addressing these symptoms in this vulnerable population.
A study of 1,718 people found that COX-2 inhibitor rofecoxib was associated with a higher risk of heart attack compared to celecoxib and older non-selective non-aspirin non-steroidal anti-inflammatory drugs (NANSAIDs). In contrast, those who used NANSAIDs had a decreased risk for myocardial infarction.
Researchers clarify that achieving an INR range of 2.0 to 3.0 is key to reducing stroke risk without increasing hemorrhage risk in atrial fibrillation patients. The study suggests that older patients with atrial fibrillation can still benefit from warfarin therapy, despite higher risks of intracranial hemorrhage.
A study found that 83% of physicians reported delays in reviewing test results, which can jeopardize patient safety and satisfaction. Physicians also identified tools to help manage test results, such as generating result letters and tracking test orders.
A new study suggests that using drugs to slow heart rate (rate control) is more cost-effective than restoring normal heart rhythm (rhythm control) for treating atrial fibrillation. The American College of Physicians released a tip sheet with these findings and several other articles on related topics.
Dementia patients experience a long, slow decline with sudden changes, making optimal care challenging. The healthcare system's focus on acute illness treatment hinders end-of-life care, resulting in poorly trained providers, systems, and patients.
A study of US travelers who died from malaria between 1963 and 2001 found that most deaths were preventable with proper medication and medical care. The researchers call for better education and resources for travelers and healthcare providers to reduce malaria-related deaths.
A study found that depressed patients experience less improvement in physical symptoms than emotional symptoms during antidepressant therapy. Physical symptoms often plateau after the initial month of treatment, emphasizing the importance of considering additional therapies.
A recent study found that popular magazines rarely provide in-depth information on prostate and colon cancer screening. Key points such as risk factors, early screening benefits, and potential harms are often missing from magazine articles. This lack of information may contribute to the public's misperception about cancer risks.
The study found that even insured individuals recognize and are willing to accept tradeoffs between having more generous benefits and having coverage for all. Insured citizens deliberated on this issue, voicing sophisticated arguments for and against giving up some of their benefits to include the uninsured.
Optical colonoscopy may miss between 10-14% of polyps, highlighting the need for virtual colonoscopy. Meanwhile, a study on West Nile fever reveals more serious symptoms and longer recovery times than previously thought. Resynchronization of heart function after a heart attack can improve quality of life but is not cost-effective.
Researchers assessed over 60,000 articles from 170 journals to determine the most clinically relevant titles. The study found that general broad interest titles and North American/European titles were among the top five most useful, suggesting that clinicians should focus on these publications.
A study by Dr. Kurt Kroenke found that depression is a risk factor for pain symptoms, with muscle pain and headaches being two or three times more common in people with depression. Physical symptoms may not respond to antidepressant treatment as well as emotional symptoms, and can linger longer.
A new study found that wearing below-the-knee elastic compression stockings every day reduces the incidence of DVT complications from 49% to 26% and severe complications from 12% to 3.5% after a blood clot in two years. The study suggests that stocking therapy should be routine after a deep-vein blood clot.
A meta-analysis found that cardiac resynchronization therapy improved the quality of life of people with heart failure, while a cost-effectiveness study showed it costs $90,000 per quality-adjusted life-year saved. Guidelines for follow-up colonoscopies were also criticized for being too often performed.
A study of 2,220 patients with acute coronary artery disease found that early invasive treatment showed a benefit in preventing heart attack or death, especially for older patients. A survey also revealed significant salary disparities between female and male medical faculty members in the US.
A study found that 65% of physicians made treatment decisions inconsistent with their patients' advance directives. Despite the presence of these documents, physicians prioritized other factors in difficult clinical situations. The authors emphasize the need for improved conflict resolution in end-of-life decision making.
Cardiovascular patients who have undergone re-vascularization procedures tend to live longer and have a better quality of life, according to the study. The guidelines provide recommendations for pre-travel preparation, including medication management and airline security protocols.
A study found that adults with regular doctors were more likely to receive influenza vaccinations and mammography, as well as advice on smoking cessation. This suggests that trust in a single provider contributes to better adherence to health recommendations.
A study of 200 adults found that physicians often misattribute physical symptoms to causes other than depression. Patients with physical symptoms were less likely to accept antidepressants and showed improved outcomes when presented with psychological symptoms.
A new study published in the Journal of General Internal Medicine found that patients who saw the same doctor after hospital treatment had a significantly lower risk of dying or being readmitted. The study analyzed data from over 938,000 adults in Ontario, Canada and found that patients who received consistent follow-up care had better...
A study found that American ginseng reduced the anticoagulant effect of warfarin in healthy volunteers. Additionally, researchers observed that only 57% of doctors followed standard hand hygiene practices, with factors such as high workload and risk for cross-transmission affecting compliance.
A study published by Marshfield Clinic found that echinacea had no effect on relieving common cold symptoms. The study involved 128 participants who took either echinacea or a placebo, with no significant difference in symptom relief observed.
Two randomized trials compared low-carbohydrate diets with low-fat diets, finding improved triglyceride levels and slightly improved HDL cholesterol levels on the low-carb diet. Participants on the low-carb diet also lost more weight in the short-term study, but both groups lost similar amounts of weight in the 12-month study.
A unique computer system developed at the University of Michigan Health System reduces risks while improving patient care quality and continuity. The Discharge Navigator system automates information transfer, streamlines handoffs, and enhances patient education and satisfaction.
A study found that only 25% of internal medicine residency programs in the US have formal instruction on interacting with drug company sales representatives. A six-hour curriculum was developed to teach residents about the ethics of these interactions and how they can be influenced by marketing tactics.
A study found that heavy alcohol consumption is associated with a slightly increased risk of colorectal cancer. The American College of Physicians task force released eight recommendations to redefine the domain of general internal medicine, suggesting a balance between breadth and depth in practice, as well as team-based care.
The length of hospital stay for patients with acute myocardial infarction (AMI) has significantly shortened over the past few decades, from six weeks in the 1950s to less than one week today. Despite this decline, there is considerable variation in hospitalization duration among AMI patients.
A study found that over a third of patients are interested in reading their medical records, with the most common reasons being to understand their condition and be more involved in healthcare. Patients who want to review their records are often those seeking alternative health information and have concerns about errors in care.
A new study of people with newly diagnosed Alzheimer disease found that median survival period was significantly shorter than similar-aged individuals. The severity of cognitive impairment and other factors were strongly associated with decreased survival. Meanwhile, the US Preventive Services Task Force recommends screening for alcoho...
A recent study found that moderate amounts of alcohol may help prevent death from cardiovascular disease (CVD) in men with hypertension. The study involved 14,125 male physicians and showed a significant reduction in CVD mortality among those who drank moderately.
A study of 299 smokers found that nicotine nasal spray and skin patch both led to similar abstinence rates after six months. However, certain groups achieved higher success rates with one form over the other based on their ethnic background, weight and nicotine dependence level.
A Northwestern University study found that death rate after hospital discharge increased up to 72 percent for patients with DNR orders. Despite this, the researchers suggest that shorter lengths of stay can be achieved without compromising patient health through improvements in therapies and end-of-life care.
Long-term Tai Chi practice promotes balance control, flexibility, and cardiovascular fitness, while reducing the risk of falls in elders. Benefits have also been reported for cardiovascular and respiratory function, as well as pain, stress, and anxiety.
The US Preventive Services Task Force finds insufficient evidence to show that routine screenings for physical abuse and intimate partner violence lead to decreased disability or premature death. Clinicians should remain vigilant and look for signs of abuse or neglect, despite the lack of proof that interventions work.
The editorial cites evidence from studies including the Nurses' Health Study and Cancer Prevention Study II, which found a correlation between adequate sleep duration and increased lifespan. These findings support the notion that getting enough sleep is essential for overall health and well-being.
A six-month graded activity program reduced lost work days by 29 days compared to usual care for patients with work-related low back pain. The program's focus on patient function despite pain was commended, but more research is needed to develop powerful treatments.
A recent study found that participants in surgery conferences were more likely to discuss medical errors as errors and attribute them to a specific cause. In contrast, conference leaders for medicine conferences missed opportunities to use explicit language in error discussion. The study highlights the need for a culture shift in ackno...
A substantial proportion of U.S. doctors support national health insurance, with 49% backing government-led legislation and 40% opposing it. Mammography screening is found to be cost-effective for women aged 65-80 with no serious health conditions, reducing death at reasonable cost.
The SARS epidemic taught four important lessons: the need for global cooperation, improved public health infrastructure, care for patients despite personal risk, and measures to minimize infectious risks to healthcare workers. The response to SARS demonstrates that a strong public health infrastructure can help contain outbreaks and pr...
A new set of guidelines aims to standardize reporting of medical guidelines, reducing misunderstandings among clinicians, patients, and reporters. Blood pressure pills have been found to lower hip fracture risk in older adults, but the protective effect disappears after four months without treatment.
Research reveals that obese individuals are more likely to develop symptoms of acute mountain sickness at high altitudes, with lower blood oxygen levels. In contrast, smoking marijuana or taking synthetic cannabinoids in HIV patients did not affect key treatment indicators, according to a new study. A no-fault medical malpractice syste...
A second gene, zinc metalloproteinase (ZMPSTE24), has been identified as a cause of the rare skeletal disorder mandibuloacral dysplasia (MAD). Mutations in this gene may also lead to premature aging, generalized loss of body fat and early death.
A study found that patients with unexplained chronic fatigue had nine times more prevalent sinus symptoms than the control group, and six times more common in those with unexplained chronic pain. Sinusitis may be a contributing factor to chronic fatigue syndrome in some cases.
A new study measures the emotions of doctors-in-training, finding that anxiety, guilt, and compassion are prevalent feelings. The research highlights the importance of acknowledging and managing these complex emotions to improve medical education and patient care.
A randomized pilot study found that alternating two triple-drug regimens every three months significantly reduced drug failure and kept the viral load suppressed. However, a cost-effectiveness study identified four strategies to determine if a sore throat is caused by bacterial infection, reducing inappropriate antibiotic use.
A new study reveals that Katie Couric's on-air colonoscopy led to a significant increase in colon cancer screenings nationwide. Colonoscopy rates jumped over 20% in the days and months following Couric's test, sustained for nearly a year. The 'Katie Couric Effect' also showed an increase in screenings among women and people under age 50.
The US Preventive Services Task Force recommends against use of beta-carotene supplements for cancer or cardiovascular disease prevention due to lack of benefit and potential harm. Lawsuits involving human subjects research are increasing, leading to more careful research and increased costs, according to experts.
A new study suggests that pneumococcal vaccination can save medical costs for individuals aged 50 to 64, particularly those at high risk of pneumococcal disease. The cost-effectiveness of vaccination is comparable to other preventive services in this age group.
A new study found that transferred patients are sicker and more likely to die than those admitted directly, damaging hospital scores on measures used by patients, insurers, and employers. The 'transfer effect' must be accounted for in hospital benchmarking tools to ensure accurate representation of quality care.
The American College of Physicians (ACP) has launched Phase II of the Medical Professionalism Charter Initiative, aiming to improve patient care and population health. The charter redefines professional conduct in healthcare, with over 90 associations endorsing it.
A recent study published in the Journal of the American College of Cardiology found that oral estrogen therapy increased C-reactive protein (CRP) levels, while transdermal estrogen therapy had no effect. The researchers suggest that the route of administration may be a crucial factor in minimizing cardiovascular risks associated with e...
The American College of Physicians recommends aiming for blood pressure levels less than 135/80 mm Hg in patients with type 2 diabetes. Thiazide diuretics and ACE inhibitors can be used as first-line agents to control blood pressure, but patients may need multiple medications.
A high-meat protein diet may accelerate loss of kidney function in women with mild chronic kidney disease, according to data from the Nurses Health Study. Meanwhile, implantable cardioverter defibrillators have been shown to significantly reduce sudden cardiac death and deaths from all causes in many patients.
A daily multivitamin and mineral supplement reduced the incidence of minor infections among healthy people over 45. Intentional weight loss was associated with a 24% lower death rate compared to unintentional weight loss.
A comprehensive analysis found that Medicare enrollees in higher-spending regions don't have better access to or quality of care, nor do they have better survival rates. In fact, those in higher-spending regions were less likely to receive preventive services.
A new study found that patients in higher-spending regions receive more care, but it does not translate to better outcomes, patient satisfaction, or access to care. Removing liver tumors by ethanol injection therapy followed by interferon therapy may reduce the risk of tumor recurrence in patients with chronic hepatitis C virus.