Articles tagged with Internal Medicine
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 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.
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.
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.
A team of UVA Health experts warns that surgeon-scientists are struggling to obtain research funding, which could lead to a decline in innovations for patients. The researchers found that internal medicine trainees are six times more likely to secure R01 grants and career development awards.
Researchers found that acute kidney injury does not predict worsening of kidney function trajectory in patients with CKD, suggesting that pre-existing kidney disease may be a major contributor. The study recommends focusing on flattening the eGFR slope and treating proteinuria to slow CKD progression.
A new study found that people with low incomes in states that expanded Medicaid received more preventive care and overall health care compared to those in non-expansion states. The likelihood of high-value care, such as medications for heart problems or osteoporosis, increased in expansion states.
A study of commercially insured adults with chronic noncancer pain found that state medical cannabis laws did not lead to a reduction in the use of opioid or nonopioid pain treatments. The researchers also suggested slow implementation and reluctance among healthcare leaders may have contributed to these findings.
The expert panel's recommendations aim to improve early detection of mild cognitive impairment in primary care, benefiting patients and caregivers. The work group advocates for the routine use of brief cognitive assessments to identify patients in need of full cognitive examination.
A randomized controlled trial found that time-restricted eating produced similar weight loss results to traditional calorie counting in a racially diverse population of adults with obesity. Participants who engaged in 8-hour time-restricted eating had improved insulin sensitivity compared to those in the control group.
Researchers found that when a patient's congestive heart failure is mentioned during the initial check-in process, emergency room physicians are less likely to test for pulmonary embolism, potentially leading to delays in diagnosis. This anchoring bias can delay crucial testing and diagnosis of deadly medical conditions.
The inaugural issue of CHEST Critical Care focuses on clinically relevant research and patient management guidance for critical care medicine. The journal accepts submissions of original research, case series, and research letters, covering topics such as intensive care medicine and diverse populations.
New research suggests optogenetics could restore regular heart rhythm without shocks, improving prognosis and quality of life for AF patients. Light therapy has shown promising results in rats, indicating potential translatability to humans.
A post-hoc analysis of the ASPREE trial found that low-dose aspirin was associated with a 20% increased incidence of anemia and decline in ferritin levels in healthy older adults. The study recommends periodic monitoring of hemoglobin for patients taking aspirin.
A new method combines ultracentrifugation fractionation, solid-phase alkylation based sample preparation, and liquid chromatography-mass spectrometry to profile the urine proteome. This approach drastically reduces analysis time by 3-4 times and enhances identification coverage by 130%-160% compared to existing methods.
A statewide pay-for-performance intervention based on Choosing Wisely reduced rates of inappropriate antibiotic prescriptions for acute respiratory tract infections from 43% to 25%. This reduction occurred without measurable harms at safety-net hospitals serving disadvantaged patients.
A study found that even insured patients with diabetes use crowdfunding platforms like GoFundMe to cover excess medical expenses, including uncovered co-pays and life-saving care. Researchers urge policymakers to consider these needs when developing affordable diabetes care policies.
A supervised hospital walking program has been shown to reduce nursing facility admissions for older adults by lowering the proportion of patients discharged to skilled nursing facilities from 13% to 8%. However, low participation rates and limited impact on length of stay or inpatient falls were noted.
A recent study published in Annals of Internal Medicine found that elderly hospitalized patients treated by physicians with MD or DO degrees had virtually identical mortality rates, readmissions, length of stay, and healthcare spending. The results suggest high-quality care regardless of the physician's educational background.
A study of nearly 67,200 postmenopausal women found that the Fracture Risk Assessment Tool (FRAX) was inadequate for identifying osteoporotic fracture risk across racial/ethnic categories. However, the Osteoporosis Self-Assessment Tool (OST) was excellent for detecting osteoporosis within each category.
Survivors of firearm injury experience chronic PTSD symptoms and poor health-related quality of life, emphasizing the need for comprehensive care. Screening for chronic kidney disease could be cost-effective for US adults starting at age 35.
A recent study published in the Journal of Clinical Immunology suggests that cutaquig infusions at higher infusion rates and volumes are well-tolerated and effective, with reduced infusion time, fewer injection sites, and improved compliance. The study results will be presented at the Clinical Immunology Society 2023 Annual Meeting.
The May issue of the CHEST journal features cutting-edge research on pulmonary, critical care, and sleep medicine. The journal also highlights awareness for cystic fibrosis, a once-fatal childhood condition now affecting adults.
A new commentary from infectious disease experts emphasizes the importance of continued masking in healthcare settings due to low evidence of efficacy and high transmission risks. Despite recent conflicting views, the authors argue that mask-wearing remains a crucial strategy for infection prevention.
A cost analysis suggests Lecanemab, an antidementia medication with modest clinical benefit, could add billions to Medicare spending each year. Beneficiaries without supplemental coverage would face substantial out-of-pocket costs.
Researchers in China have created a simple nomogram using easily accessible and automatable detected routine clinical indicators to reduce missed diagnosis and misdiagnosis of Wilson's disease. The study identified six independent predictors of the disease, including serum copper and direct bilirubin.
A study presented at Digestive Disease Week found that nearly 40% of TikTok posts about liver disease contain false or misleading information. Inaccurate claims often push fad diets, detox drinks, and herbal remedies as cures, with little engagement compared to accurate posts.
Researchers found that heavy alcohol use and the presence of metabolic syndrome were associated with a higher risk for advanced liver disease. The study suggests an increasing interaction effect between MetS, heavy alcohol use, and a recent surge in alcoholic liver disease-related mortality.
A sharp increase in colchicine's price led to a 17% drop in its use and worsened disease control in gout patients. Patients turned to alternative medications with potentially different side effects, resulting in increased emergency department visits and specialist consultations.
Researchers found that people who perceived cognitive difficulties during COVID were more likely to experience physical symptoms of long COVID. The study suggests a psychological component for lingering SARS-CoV-2 symptoms in some patients.
A study of 371,159 individuals aged 50 to 71 years found that a healthy low-fat diet was associated with fewer deaths from all causes, cardiovascular diseases, and cancers. In contrast, unhealthy low-carbohydrate diets were linked to significantly higher mortality rates.
A cohort study of 196 people treated with tecovirimat found that HIV status did not impact treatment outcomes. Only 22% of participants experienced nonsevere adverse effects, and 4 serious adverse events occurred, with 3 being persons with HIV. The findings contradict previous uncertainty about HIV's role in mpox acquisition.
A growing number of states have implemented policies to cover outpatient hemodialysis for undocumented immigrants with kidney failure. This expansion may be due to increased awareness of poor outcomes with emergency hemodialysis and advocacy efforts. The move towards covering dialysis in all 50 states is called for by experts, who also...
The 18th Key Symposium on Healthy Ageing and Longevity takes place in Okinawa, bringing together world experts to discuss the latest research on blue zones. The symposium aims to promote both longevity and healthy ageing to reduce age-related diseases and healthcare burden.
Small vesicles released by intestinal bacteria induce immune activation and progression of liver cirrhosis, as well as reduction of serum albumin level, leading to edema and ascites in patients with cirrhosis.
Experts recommend managing SARS-CoV-2 like other endemic respiratory viruses using Standard and Transmission-based Precautions. They also suggest reconsidering pandemic-era strategies such as asymptomatic testing and contact tracing in the endemic era.
A study of over 43,000 adults found that parathyroidectomy has no estimated effect on long-term kidney function in older adults. However, early treatment may preserve kidney function in patients younger than 60 years old.
A study published in the Journal of Internal Medicine found that patients with liver disease who took the drug ursodeoxycholic acid had a 46% lower odds of being infected with SARS-CoV-2. This was associated with reduced symptoms and severity of COVID-19.
Researchers analyzed 2,571 patients treated with monoclonal antibodies and found a 39% reduced risk of hospitalization or death compared to non-treated peers. The study also showed greater benefit in patients with immunocompromising conditions and those treated earlier during the pandemic.
Researchers found that using monoclonal antibodies within two days of a COVID-19 diagnosis reduced the risk of hospitalization or death by 39% compared to those who did not receive treatment. This finding suggests that early treatment with monoclonal antibodies significantly reduced the severity of COVID-19.
A randomized clinical trial found that a video-based decision support tool increased patient knowledge, but not assent, to ICD implantation among Black patients. The study also highlighted the complexity of aversion to cardiac procedures in Black communities, emphasizing the need for further research on social determinants of health.