Articles tagged with Internal Medicine
Two University of Iowa studies examine factors that hinder or help physicians disclose medical errors. The research reveals a range of positive and negative motivations, including responsibility to patients, self, profession, and community. Understanding these factors can improve patient safety and doctor-patient relationships.
A team of medical experts has established clinical guidelines to inform the best care for patients with pacemakers or implantable cardioverter-defibrillators under advisory or recall. The guidelines consider device failure rates, patient dependency, and mortality to guide replacement decisions.
The second edition of 'Medicine in Quotations' features over 450 new quotations on various topics, fully referenced to their original sources. The book offers a unique perspective on the evolution of medical concepts and practices.
A study by Jasminka M. Vukanovic-Criley and colleagues found that cardiac examination skills appear similar among medical students, residents, and faculty physicians, but decline significantly after years in practice. The authors conclude that improvement is needed to ensure accurate diagnosis and patient safety.
Patients who received a disclosure were more likely to correctly identify their physician's payment model and report enough knowledge to judge its influence on health care. Loyalty to the physician group was higher among those receiving a disclosure, with no significant decrease in trust.
The article discusses scientific fraud prevention and the growing concern of community-acquired MRSA infections. The key responsibilities for addressing misconduct can be shared among institutions, co-authors, and journal editors.
Researchers found that physical symptoms of frailty are often reversible and can be addressed through early intervention. The study, published in Archives of Internal Medicine, included 754 participants aged 70 or older and found high rates of recovery from frailty.
A 15-year study found that elderly men with higher optimism levels had a significantly lower risk of cardiovascular death. The study also showed that older age, depression, and lower physical activity were associated with lower optimism scores over time.
A national survey found that 78% of hospitals do not require general pediatricians to be board certified at the time of initial privileging, but 70% require it at some point during their tenure. Many hospitals have no specific time limit for certification,
A study published in the American Journal of Public Health found that using open-ended questions to collect patient-reported data on ethnicity resulted in lower rates of missing values and unusable data compared to traditional closed-ended methods. This method also better captured the nuances of patients' self-identified ethnicities.
A study by Dr. Richard Frankel found that nonverbal cues in medical interactions can influence patient satisfaction and compliance with doctor's instructions. Effective nonverbal behavior can convey empathy and improve communication, whereas inappropriate gestures can lead to feelings of humiliation or anxiety.
Researchers report three cases of severe liver failure and hepatitis linked to telithromycin, a newly approved antibiotic. The study highlights the potential risk of idiosyncratic drug reactions at one medical center.
A survey of internists reveals the most common reasons for recertification are to maintain professional image and update knowledge. In contrast, a review finds no evidence that oral nutritional supplements help elderly patients in a home setting. Meanwhile, unsupervised walking at home can slow decline from peripheral arterial disease.
A Northwestern University study found that self-directed walking exercise at least three times a week slows the decline of physical abilities in people with peripheral artery disease (PAD). Participants with the worst PAD at the start of the study were most likely to benefit from this type of regular exercise program.
59% of general internists, 60% of subspecialists participated to improve professional image and update medical knowledge. The survey also found that 69% of general internists believed board-certified physicians are more competent than non-certified ones.
A Yale University study found that the true number of chronically disabled older Americans is significantly lower than previously estimated, with only 16.1-17.2% of participants meeting criteria for chronic disability
A recent study by Yale University researchers found that US Medicare patients with heart failure have a lower risk of dying within 30 days compared to their Canadian counterparts. However, the difference in long-term survival rates is negligible. The study suggests that the American system may excel at acute care, while the Canadian sy...
Researchers found that higher levels of inflammatory markers Lp-PLA2 and CRP were associated with increased risk of ischemic stroke. The study included 12,762 middle-aged men and women, and found that individuals with high levels of both markers were at the highest risk.
A study of nearly 2500 HIV-infected adults in the US found that 26% experienced perceived discrimination, with physicians being a major contributor. This discrimination led to reduced access to care and lower ratings for medical quality, highlighting the need for addressing these issues.
The ACP Expert Guide to Sports Medicine covers assessment and management of common musculoskeletal injuries and other sports-related conditions. The book is organized in three sections: Overview, Medical Conditions (non-musculoskeletal), and Musculoskeletal Injuries, with tables, illustrations, and case studies.
Researchers at Yale School of Medicine found that expanded physician and residency training in telephone medicine is necessary to prevent medical mishaps. The lack of visual cues indicating emotions may lead physicians to assume patients take news better than they actually do.
A study of Medicare patients with heart attacks found significantly higher 30-day death rates in December compared to other months, with 22% of those hospitalized in the month dying within 30 days. The study looked for use of proven therapies but authors remain uncertain about the cause of the increased mortality rate.
A new UCLA study found that seniors with the lowest expectations for aging were more than twice as likely to report engaging in less than 30 minutes of moderate to vigorous activity. Increasing physical activity can improve health outcomes for older adults, making it a powerful way to address common age-related health issues.
The number of students in US medical schools remained constant between 1994-1995 and 2004-2005, at approximately 67,000. Meanwhile, full-time faculty members increased by 32%, with many specialties experiencing an influx of new recruits.
The US Preventive Services Task Force recommends routine genetic counseling for women with a family history of breast cancer or Ashkenazi Jewish descent. A new study found that tiotropium, an inhaled bronchodilator, reduces COPD flare-ups and hospitalizations compared to a placebo.
A study by UT Southwestern researchers found significant differences in C-reactive protein levels among men and women, as well as between black and white patients. Women typically had higher CRP levels than men, while blacks had higher levels than whites, with a notable disparity in cardiovascular disease rates.
A study found that hospitalised older patients with delirium had a 13% shorter lifespan compared to those without delirium. The researchers estimate that this equates to approximately one year of life lost per patient.
Primary care physicians overwhelmingly believe that annual physical examinations provide valuable time for counseling on preventive health behaviors and improve the physician-patient relationship. Despite current guidelines recommending more selective screening, many PCPs perform annual exams due to patient demand and perceived benefits.
Physicians performing independent medical examinations (IMEs) still owe legal duties to patients, even without traditional relationships. The U.S. health care provider market is a key factor in rising health care costs, with strong market power driving high prices and quantity of medical services.
A recent study published in Patient Education and Counseling found that 89% of women overestimated their lifetime risk of breast cancer, with an average estimate of 46%. Women who did not provide an estimate beforehand were more likely to feel anxious, while those who provided an estimate reported relief after learning the actual risk ...
ID physicians and expert general medicine physicians outperform non-expert generalists in treating patients with HIV. Key findings include improved viral load control and increased flu vaccination rates among expert groups.
Major medical journals, including Annals of Internal Medicine, will consider publishing results of clinical trials only if they are registered in a publicly accessible database before enrollment begins. The International Committee of Medical Journal Editors (ICMJE) has adopted a set of 20 required data elements for trial registration.
Ralph Horwitz, M.D., is receiving the Glaser Award from the Society of General Internal Medicine (SGIM) in recognition of his significant contributions to research and education in general internal medicine. The award is supported by grants from the Henry J. Kaiser Family Foundation and the Commonwealth Fund.
A study of 47,620 male health professionals found that vigorous physical activity reduced the risk of advanced and fatal prostate cancer by up to 70% among men aged 65 or older. However, no association was observed for younger men.
Researchers found that patients motivated for assisted suicide due to chronic illness, loss of sense of self, or fear of future decline. These motivations highlight the need for healthcare providers to address the quality of dying experience with their patients.
A study examining nearly 100,000 patients found that nearly half did not receive recommended laboratory tests to monitor potential drug side effects. The researchers conclude that lapses in drug safety monitoring are common and further research is needed to determine the extent of its impact on actual medical problems.
A Georgetown University researcher reveals hidden sponsorship of articles and lectures in medical journals, compromising patient care. A public database is needed to disclose conflicts of interest.
A recent editorial in the Journal of General Internal Medicine condemns the practice of ghostwriting in medical journals, citing issues with authorship and financial relationships. The authors highlight the need for transparency and accountability in academic publishing to maintain public trust.
The new Ethics Manual revisits and expands on earlier topics, including sections on chaperones and privacy, gifts from patients, and health and human rights. The fifth edition provides an ethical framework for physicians to make complex decisions in a changing environment.
A study published in Archives of Internal Medicine found that physicians with negative attitudes towards injection drug users were less likely to prescribe highly active antiretroviral therapy (HAART) and had a higher rate of complaints. Additionally, researchers discovered that patients who received financial disclosure about physicia...
A new study published in Annals of Internal Medicine found that obese patients with type 2 diabetes who followed a very low-carbohydrate diet lost significant amounts of weight. The participants consumed fewer calories on the low-carb diet, resulting in improved blood sugar levels and reduced triglycerides and cholesterol levels.
A recent study found that pregnant women who engaged in regular exercise had improved mental health and reduced symptoms of depression. The research suggests that moderate exercise, such as 30 minutes a day, can help counteract the negative effects of pregnancy on physical and mental well-being.
A recent study found that only 1 in 4 minority women under 40 have documented family history of breast cancer. The research highlights the need for primary care providers to ask about breast cancer histories, as disparities were observed between minority and white women.
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 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.
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.
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.