Articles tagged with Internal Medicine
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.
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.
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 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.
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.
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.
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 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.
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 study examining ephedra's effects found it was more likely to cause negative side effects than other herbs; sale of ephedra as a supplement should be restricted or banned due to increased risk. A hospital discharge period is also deemed dangerous for patients, with one in five experiencing adverse events after going home.
Smallpox experts suggest limiting vaccinations to first responders to prevent complications and ensure public safety. The authors cite studies from the 1960s documenting vaccine-related complications, including spread to close contacts and increased risk of morbidity and mortality.
A study of over 3,357 people found that excess weight can cut years off a person's life, with smokers losing up to seven years. Meanwhile, hormone therapy was shown to lower the risk of diabetes in postmenopausal women by 35%.
A study analyzing Boston smallpox case records found that young patients, those unvaccinated, and those with severe disease had the lowest survival rates. In contrast, a college student study on echinacea found no effect on cold symptoms, highlighting the need for more research into its efficacy.
The American College of Physicians and the American Academy of Family Physicians have released new guidelines for treating migraines, recommending immediate treatment with NSAIDs or triptans, as well as managing nausea and vomiting symptoms. The guidelines also emphasize the importance of patient involvement in charting migraines and i...
A study of 75 patients found that postponing care for those with non-serious illnesses had comparable health outcomes to immediate care. Additionally, a new combination therapy for arthritis patients showed promise in reducing joint symptoms and improving function.
Methadone treatment is being expanded to office-based practices for patients with addiction, aiming to make it more accessible. Hair analysis has been found to be a significant advance in assessing exposure to antiretroviral therapies and monitoring patient response to indinavir, an anti-HIV drug.
Two studies found that patients with kidney disease are at increased risk of death after a heart attack, receiving less-aggressive treatment. Meanwhile, researchers report four cases of muscle damage caused by statins, highlighting the need for closer monitoring.
A researcher has reviewed over 350 clinical studies to find evidence-based therapies for stroke prevention, highlighting the underutilization of anti-coagulation therapy in high-risk patients. The study aims to make this evidence accessible to clinicians to improve healthcare outcomes.
A Canadian National Breast Cancer Screening Study found that annual mammography for five years had no impact on breast cancer deaths in women aged 40-49. The US Preventive Services Task Force recommends starting mammography at age 40, but evidence is considered 'fair' due to conflicting results.
A retrospective analysis of 4,054 study participants found that enalapril, an ACE inhibitor commonly given to patients with heart failure, is effective in both black and white populations. Despite equal response rates, black patients still had increased rates of progression to heart failure.
The American College of Physicians recommends screening adults over 50 for colorectal cancer. The Task Force identified two screening methods that have been shown to reduce death from colorectal cancer: the fecal occult blood test and flexible sigmoidoscopy.
The ACP-ASIM published 'Osteoporosis' guide provides the latest scientific evidence on osteoporosis and essential information on its origins and progress. It addresses every facet of osteoporosis, a common disease that can be identified through non-invasive tests and treated with new effective drugs to reduce fractures.
The US Preventive Services Task Force (USPSTF) advises women at low risk for breast cancer to avoid taking drugs like tamoxifen or raloxifene. Women at high risk, however, should have open discussions with their doctors about the benefits and risks of these medications.
Celebrating its 75th anniversary, Annals of Internal Medicine has published influential articles on Lyme disease, HIV/AIDS, and evidence-based medicine. The journal has continued to evolve with innovative features like structured abstracts and international discussions on editorial issues.
A study of 373 intravenous drug users found significant reductions in emergency department use among those using needle-exchange programs, including Hispanics, men, and those with mental illness. The study suggests that needle-exchange-based health care services can reduce emergency department use among high-risk IDUs.
A study found contaminated E. coli bacteria in hot sauces from popular tourist restaurants in Mexico and Texas, increasing the risk of travelers' diarrhea. A simple test can detect peripheral arterial disease by comparing blood pressure in the arm and lower leg.