Articles tagged with Internal Medicine
A study of over 1.6 million ED visits found that nearly two-thirds of low-risk pulmonary embolism patients were hospitalized, despite evidence suggesting safety in outpatient management. Researchers suggest further investigation into ED triage decisions to improve appropriate use of outpatient care.
In a randomized clinical trial of 1,068 smokers, electronic cigarettes were shown to be as effective as varenicline in aiding smoking cessation, while being more effective than nicotine chewing gum. The study suggests that e-cigarettes may offer a viable alternative for quitting smoking with minimal behavioral support.
A study of 57,000 US adults found that lower levels of food security are associated with a higher risk of premature mortality and shorter life expectancy. The findings highlight the potential importance of improving food security in promoting population health and reducing health disparities.
A recent study of 35,000 adults aged 50+ found significant inequities in survival rates associated with wealth inequality in the US. Wealth redistribution policies have been proposed as a solution to reduce these disparities and increase population longevity.
A cross-sectional study of over 6,500 adults aged 65+ found that older adults spent an average of 20.7 days per year receiving healthcare outside the home. The 'health care contact days' metric can help evaluate care and identify areas for improvement, such as coordinating tests with visits and reducing Friday office visits.
A recent study found that primary care physicians' electronic health record (EHR) workload has continued to grow, with PCPs spending nearly 30 minutes more on EHR tasks per clinic appointment between 2019 and 2023. This increased burden can lead to burnout and affect their ability to provide adequate care.
Researchers have developed a novel sequential ultrasound molecular imaging (USMI) approach to identify non-alcoholic steatohepatitis (NASH), offering a potential noninvasive diagnostic tool. The method uses microbubbles targeting CD36 and ICAM-1 to visualize hepatic steatosis and inflammation.
A clinical trial found that trazodone and cognitive behavioral therapy for insomnia were no more effective than placebo in improving insomnia symptoms among long-term dialysis patients. Serious adverse events also occurred more frequently with trazodone use. More trials are needed to investigate additional therapies for this condition.
A new poll found that only 7.5% of people between 50-80 have used at least one direct-to-consumer health care service, with most receiving prescriptions for a one-time treatment. Many users didn't inform their regular providers about the prescriptions.
Diagnostic errors in hospitalized adults who died or were transferred to the intensive care unit were common, with problems in test choice and clinician assessment identified as high-priority areas for improvement. The study analyzed 2,428 patient records at 29 hospitals and found that these errors led to significant patient harm.
Researchers found that specific microbes in the gut reduce graft versus host disease after stem cell transplantation. Patients with low microbial metabolite risk index had better survival rates, fewer graft vs. host reactions, and reduced relapses.
A study of over 5,000 adults found that acute hospital care at home (AHCaH) is associated with low mortality, escalation, and readmission rates among medically complex and socially vulnerable patients. AHCaH was also linked to improved experiences and physical activity levels.
The American College of Physicians (ACP) recommends removing barriers to participating in the electoral process to advance health equity. ACP supports policies ensuring safe and equitable access to voting, opposes partisan gerrymandering, and encourages civic participation among healthcare professionals.
A systematic review and meta-analysis of 15 clinical trials found daily tooth brushing may reduce hospital-acquired pneumonia rates by up to 50% in high-risk patients. This study suggests that widespread toothbrushing policies could save lives and reduce healthcare costs.
A recent study published in Gastroenterology & Endoscopy found that narrow-band imaging at low magnification can detect lesions missed by white-light imaging. Annual endoscopic examinations using LM-NBI revealed a threefold higher detection rate of neoplastic lesions compared to conventional magnifying endoscopy.
Research reveals SARS-CoV-2 RNA presence in extracellular vesicles of patients with negative PCR tests, suggesting a potential source for recurrent infections. The discovery may aid in identifying individuals with persistent or recurrent COVID-19 infections and offer new avenues for therapeutic interventions.
A Northwestern University study found that nearly two-thirds of patients discontinue or change their medication within a year, highlighting the need for better understanding of barriers to treatment adherence. The high discontinuation rate for GLP-1 RAs may be due to gastrointestinal side effects.
According to a new study published in Annals of Internal Medicine, most adults who qualify for statin use for primary prevention are not receiving them. The study found that despite increased overall statin use over time, only 35% of eligible adults were taking statins between 2013 and 2018. The researchers suggest that innovative effo...
Researchers at Osaka Metropolitan University have successfully developed a novel pneumococcal vaccine that demonstrates efficacy in suppressing pneumococcal pneumonia in macaques. The vaccine's design combines proprietary mucosal vaccine technology with pneumococcal surface proteins to cover a wide range of serotypes.
A randomized trial found that unfiltered traffic-related air pollution caused a rapid and significant increase in blood pressure, which persisted for more than 24 hours. The study suggests that effective cabin air filtration may reduce the negative effects of air pollution on blood pressure.
A study of 438,000 U.S. adults found that smoking cessation can significantly reduce cardiovascular, cancer, and respiratory mortality rates. Within a decade of quitting, former smokers' risk of cardiovascular death was approximately one-third that of continuing smokers.
A study of over 2.9 million patients found that gender concordance was associated with lower mortality for female patients, but higher mortality for male patients. The quality of surgical care provided by female surgeons is equivalent to or slightly better than that provided by male surgeons.
The COVID-19 pandemic and drug overdose epidemic significantly contributed to the widening gender gap in US life expectancy. Chronic metabolic disease and mental illness are also thought to play a role in the growing disparity.
A study found that 20% of patients treated with nirmatrelvir-ritavir (N-R) experienced virologic rebound, a phenomenon where viral load increases after initial decline. In contrast, only 1 untreated patient was affected. The researchers suggest considering the risks and benefits of N-R treatment in patients at low risk for severe disease.
A nationally representative survey reveals a shift in tobacco use among young adults, with historically low cigarette use and higher e-cigarette use. Exclusive e-cigarette users are unlikely to transition to combustible tobacco.
Researchers found that acupuncture improved symptoms in patients with chronic spontaneous urticaria (CSU), but the benefits were not significant enough to meet the minimal clinical difference threshold. The study included over 300 participants and suggested that clinicians should consider using acupuncture as an adjunctive treatment.
A study found that physicians who presented treatments for obesity as good news and an opportunity were more successful in helping patients lose weight. Patients who received counseling with a positive and optimistic tone had significantly higher weight loss outcomes compared to those who received neutral or negative advice.
A novel multicomponent intervention aimed at improving patient access to kidney transplants did not significantly increase the rate of completed steps in a randomized clinical trial involving 20,375 patients. The study highlights the need for sustained efforts to address barriers to transplantation globally.
Research at Niigata University demonstrated the GH-IGF-1 axis's role in inhibiting fatty liver disease progression. The study highlights the significance of brain peptide dynamics in maintaining pathological homeostasis, suggesting therapeutic potential for IGF-1 release.
A recent study published in Annals of Internal Medicine found that both nurse practitioners (NPs) and physicians are similarly likely to inappropriately prescribe medications to older patients, with an average of 1.7 inappropriate prescriptions for every 100 prescriptions written. The authors suggest that use of clinician-level perform...
A study of 222 US hospitals found that 79.4% of patient-facing websites did not mention abortion, with limited information provided when it was mentioned. This lack of disclosure may contribute to stigma surrounding abortion care.
The study reveals that dementia significantly affects an older adult's long-term care and financial status, with incremental changes being substantial. Family care availability should be considered in assessing the effects of dementia on caregivers' lives.
The University of Louisville is increasing training for medical students in rural communities and West Louisville to prepare them for primary care careers. The grant will enhance programs that attract and train physicians to practice in medically underserved regions.
A new study published in JAMA Network Open suggests that reattribution of pain to mind or brain processes can lead to significant reductions in chronic back pain intensity. Participants who received pain reprocessing therapy reported being pain-free or nearly so after treatment, compared to those receiving placebo controls.
Adult Black patients experience higher risk of physical restraint in emergency departments compared to other racial groups, according to a systematic review and meta-analysis. The study emphasizes the importance of considering how racism may affect disparate use of restraints among adult patients.
A study of over 15,000 individuals with chronic kidney disease found that young age, Black race, and low education and income were linked to lower flu vaccine uptake. The study suggests that targeted vaccination efforts could improve uptake among those with kidney disease.
The September issue of the CHEST journal features research on long COVID, including a review on exercise pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2. Original studies also explore asthma treatment with albuterol-budesonide inhalers and sleep therapy using oronasal masks.
The American College of Physicians has issued updated rapid, living practice points on treating COVID-19 patients in outpatient settings. The new guidance supports the use of molnupiravir or nirmatrelvir-ritonavir for symptomatic patients with confirmed mild to moderate COVID-19.
A new study reveals that over half of adult patients skip questioning about firearms on screening questionnaires, while surveyed primary care providers are often uncomfortable discussing firearm safety with most patients. The study suggests a need for more research and improved training on firearm-related topics for primary care clinics.
In a cohort study of 2,055 patients with glomerular diseases, COVID-19 vaccination did not worsen kidney damage or affect proteinuria. The data support vaccination for COVID-19 in patients with glomerular disease.
Researchers found a significant disparity in out-of-hospital cardiac arrest survival rates between Black and Hispanic EMS agencies in certain areas, with lower rates reported in these agencies. The study's findings suggest that further assessment is needed to address these discrepancies.
A nationally representative study found that at least one out of five prescriptions for commonly prescribed generic medications were cheaper through Amazon Prime or GoodRx Gold discount cards compared to actual out-of-pocket payments made by patients. The findings highlight the disproportionately higher frequency of out-of-pocket payme...
Two studies demonstrate that artificial intelligence in colonoscopy can increase adenoma detection rates and reduce miss rates, but also lead to increased removal of non-neoplastic polyps. The findings suggest the need for additional research on more defined detection parameters before AI can be integrated into routine clinical care.
A systematic review and meta-analysis of 18 clinical trials involving 2.1 million individuals found no significant lifetime gain from common cancer screening tests. However, colorectal cancer screening with sigmoidoscopy may have a potential benefit, according to the study.
Researchers at UCLA have found that embedding study recruitment in pre-appointment check-in pages can increase participation rates up to 40 times higher than traditional methods. The new technique, called preCheck-in recruitment, resulted in a socio-demographically representative patient population without financial incentives or staff...
Public health experts recommend continuing routine mask-wearing in healthcare settings to protect vulnerable patients and staff from COVID-19. The authors argue that while severe cases have decreased, asymptomatic spread remains a threat, particularly among high-risk patients and healthcare workers who may not be aware they are infected.
An intensive lifestyle intervention was associated with increased employment rates and improved labor market outcomes. The study suggests that such interventions can positively impact individuals with type 2 diabetes, highlighting the importance of considering labor market productivity in disease management.
A nationally representative study found that higher residential levels of fine particulate matter were associated with greater rates of incident dementia. The findings suggest that intervening on key emission sources could have value in reducing dementia risk, although further research is needed.
A study published in Liver Research found that glucokinase activators (GKAs) improved glucose tolerance and insulin sensitivity in mice with diet-induced obesity. However, GKAs also induced hepatic lipid accumulation, which activated the PERK-UPR signaling pathway.
The Keck School of Medicine's Primary Care Program has shown a significant increase in primary care residency matches and representation, particularly among underrepresented groups. The program provides skill-based training, mentorship, and community-focused experiences that prepare students for careers in primary care medicine.
A randomized crossover trial involving 195 adults showed that using a regular cuff size resulted in inaccurate BP readings. The study emphasizes the need for individualized cuff selection to ensure accurate blood pressure measurements.
Researchers found that adults who experienced violence, financial stress, or separation from parents as children were more likely to experience physical and cognitive impairments. Adverse childhood experiences can have lifelong consequences, including difficulty walking, carrying out daily activities, and problems with memory.
The American College of Physicians recommends starting colorectal cancer screening at age 50 for asymptomatic adults with average risk. The guideline aims to balance benefits and harms of screening in this population. Screening in younger adults may not offer significant net benefit due to lower incidence rates.
A significant racial gap exists in M.D.-Ph.D. training, with Black students facing a 50% higher risk of leaving compared to their white peers. The study reveals that 29% of Black students did not complete their training, highlighting the need for targeted support and interventions.
A recent study found that higher plant protein intake is associated with lower risk of chronic kidney disease. The UK Biobank study data revealed that participants consuming more plant-based protein had a reduced risk of developing CKD.
The American College of Physicians recommends a federal pandemic preparedness plan, prioritizing health equity and real-time data sharing. ACP also calls for bolstering healthcare supply chains and supporting medical practices during emergencies.
A study of 538,000 deaths in Florida and Ohio between March 2020 and December 2021 found significant excess mortality among Republican voters compared to Democratic voters. The disparity suggests differences in vaccination attitudes and uptake may have influenced pandemic severity and trajectory.
A study comparing history of present illness summaries generated by a chatbot and senior internal medicine residents found that both were graded similarly by internal medicine attending physicians. The findings suggest the potential of chatbots to aid clinicians with medical documentation, highlighting their accuracy.
A team of medical leaders recommends a sustainably funded public-private partnership to combat misinformation, citing challenges faced by the TIOS-VY organization. The American College of Physicians calls for modernizing public health infrastructure, including increased funding and addressing disinformation, especially on social media.
The American College of Chest Physicians has launched CHEST Pulmonary, a new online publication dedicated to pulmonary and sleep medicine. The journal features original research, case series, and reviews on various topics, including implementation science and artificial intelligence applications.