Articles tagged with Internal Medicine
A study by researchers at UCSF found that e-cigarette use costs the US $15 billion annually in healthcare expenditures, with each user paying around $2,000 extra per year compared to non-users. The study, published in Tobacco Control, highlights the growing concern over health care costs associated with e-cigarette use.
A review of 38 randomized controlled trials found that counseling patients about contraceptive use and providing contraceptives increases use without increasing STI risk or reducing condom use. The interventions also decrease unintended pregnancy in trials designed to evaluate this outcome.
A protocol-based potassium supplementation strategy resulted in a longer time to the first peritonitis episode and a lower hazard ratio of peritonitis compared to reactive supplementation. This approach also improved PD-related outcomes by significantly reducing the risk of peritonitis.
A new analysis of nationally representative data reveals a significant increase in the impact of HPV vaccination efforts, leading to decreased prevalence of cancer-causing HPV infections among both vaccinated and unvaccinated females. The study found that vaccination has directly protected individuals and generated herd effects, reduci...
State bans on affirmative action policies are associated with lower enrollment of underrepresented minority students in public medical schools. The study found a 5.5 percentage point decrease in enrollment of underrepresented students relative to control schools.
A new UCLA-led study finds that affirmative action bans in states led to a decline of 37% in the proportion of underrepresented students in public medical schools. This decrease had a devastating impact on the diversity of the physician workforce, which is crucial for providing equitable healthcare services.
A new study validates the Canadian Syncope Risk Score as a reliable tool to identify patients at low risk for serious outcomes after 30 days, potentially reducing hospitalization rates. The score showed better performance than another validated score, but its clinical utility remains uncertain and warrants further research.
A nonrandomized controlled trial of 501 patients found that awake prone positioning was linked to better oxygenation and reduced mortality rates among those with COVID-19. The study suggests that this positioning technique may be a valuable adjunct to other treatments for patients with severe respiratory symptoms.
Dr. Anil N. Makam, Assistant Professor of Medicine at UCSF, received the fifth Arti Hurria Memorial Award for Emerging Investigators in Internal Medicine Who are Focused on the Care of Older Adults. His research focuses on long-term acute care hospitals and evidence-based medicine.
Patients with mild to moderate kidney disease and kidney transplant recipients had a higher risk of cancer. They also faced a higher risk of dying from cancer, particularly from cancers such as bladder, kidney, and multiple myeloma, compared to those with normal kidney function.
A recent UCLA study found that the injury rate for e-scooter riders in Los Angeles is higher than the national rates for motorcycle, bicycle, car, and pedestrian injuries. The study estimates 115 injuries per 1 million e-scooter rides, highlighting a growing risk as e-scooters proliferate globally.
A team from Goethe University has identified the spatial structure of the mannitol-synthesizing enzyme MtlD in Acinetobacter baumannii, which is crucial for its survival. This discovery could lead to the development of customized substances to inhibit the enzyme and combat this hospital pathogen.
A California study found that adults living with handgun owners had twice the homicide rates compared to those without, with most victims being women. Survivors of nonfatal gunshot injuries also experienced significant healthcare costs and worsening mental health.
A large cohort study found that babies born to men who took metformin during sperm development were at increased risk for genital defects in boys. Diabetes control affects sperm quality, so men should discuss alternative treatments with their doctors before conception. The findings suggest a need for further study on treatment of prosp...
Dialysis facilities referred more incident patients, transplant centers evaluated more, but fewer were placed on the waitlist following KAS implementation. This led to a decline in overall waitlisting nationwide.
A study of insurance claims data found that state laws governing opioid prescribing had a negligible effect on opioid prescribing trends. The authors suggest that shifting clinical guidelines, professional norms, or other factors may be driving the decline in opioid prescribing. In contrast, a post-hoc analysis of an ASPREE trial found...
A new study led by UC San Francisco reveals that 87% of seniors with dementia would stop at least one medication if their doctor said it was possible. Polypharmacy contributes to challenges with adherence and adverse interactions, but most patients are willing to reduce their medications.
A modeling study suggests that breast cancer overdiagnosis may occur in about 15% of screen-detected cases, rather than the estimated 30%. This could spare around 25,000 women unnecessary treatment. Researchers used data from the Breast Cancer Surveillance Consortium to estimate the rate of overdiagnosis.
A cost-effectiveness analysis found that adherence promotion programs like MAPS reduce costs and improve outcomes for adolescent kidney transplant recipients. Strategies with similar costs to MAPS can still be cost-effective if they decrease rejection episodes by a small amount.
A new study has found that tubal ligation is no more effective than an intrauterine device (IUD) in preventing pregnancies. The six-year analysis of Medi-Cal claims data showed that hormonal IUDs were more effective, while copper IUDs were as effective as tubal ligation in preventing pregnancies.
Young adults are disproportionately excluded from kidney transplantation, with only 1.8% of Black and 4.4% of Hispanic patients receiving the treatment compared to 10.9% of White patients within this age group. The study highlights the need for targeted interventions to address these disparities.
A study of 2,800 adults aged 75+ found that severe financial strain increased the risk of death in the six months following a heart attack. The research highlights the importance of addressing financial stress for older adults with cardiovascular disease.
A new study shows that ZIP code social vulnerability index is linked to COVID-19 severity, with more disadvantaged areas experiencing higher symptom rates. However, differences disappear when patients are discharged from hospitals, suggesting equal access to care plays a crucial role in reducing initial disparities.
A study found that COVID-19 patients from high-vulnerability neighborhoods presented with more severe illness and required intensive care, but did not experience higher mortality rates. Researchers suggest policies targeting socially vulnerable neighborhoods to improve access to testing, treatment, and vaccination.
A study examined the association between county-level prescription rates of hydroxychloroquine and ivermectin and voting patterns in the 2020 US presidential election. The analysis found a statistically significant correlation between higher prescription rates and Republican vote shares.
A 5-day course of oral ivermectin failed to reduce the risk of severe disease in high-risk patients with COVID-19. The study, published in JAMA Internal Medicine, suggests ivermectin may not be an effective treatment for COVID-19.
A retrospective cohort study of patients with atrial fibrillation and diabetes found that non-vitamin K antagonist oral anticoagulants (NOAC) were associated with a lower risk of diabetes complications and mortality than warfarin. The study suggests that NOAC may be a better therapeutic choice for this patient population.
Patients with severe coronary artery calcium have a significantly increased risk of major adverse cardiovascular events during thoracic radiation therapy for non-small cell lung cancer. The study found that patients with severe coronary artery calcium had a 21.4 times increased risk compared to those with no coronary artery calcium.
Dr. Edward Y. Lee, MD, MPH, receives the highest distinction from North America's first radiological society for his contributions to pediatric thoracic imaging and education. The ARRS Gold Medal honors his tireless efforts to advance radiology globally.
A study of continuous monthly mortality data found that excess deaths associated with COVID-19 reached greater peaks than most other periods of excess deaths since 1918. The relative excess of deaths in 2020 was 12.5% in Switzerland, 8.5% in Sweden, and 17.3% in Spain.
Researchers found a markedly increased risk of carditis associated with BNT162b2 vaccination, particularly in adolescents after the second dose. The study's findings highlight the need for refined vaccination strategies to balance risk and benefits across different sub-populations.
The American College of Physicians (ACP) has released two new clinical guidelines for the diagnosis and management of diverticulitis. The guidelines recommend that clinicians manage most patients with uncomplicated disease in outpatient settings without antibiotics, while patients with complicated disease should be referred for colonos...
Dr. Mark S. Parker, MD, FACR, has been recognized as the 2022 ARRS Distinguished Educator for his outstanding contributions to radiological education. He will be formally recognized at the ARRS Annual Meeting in New Orleans, LA on May 1, 2022.
A case series found that a fourth dose of an mRNA-based vaccine increases antispike IgG titers in kidney transplant recipients with weak serologic response after three doses. The researchers noted no safety concerns with the additional dose and suggested its use for such patients.
A cross-sectional study found that mild autonomous cortisol secretion (MACS) predominantly affects women, increasing the frequency and severity of hypertension and type 2 diabetes compared to nonfunctioning adrenal tumors. Patients with MACS carried an increased cardiometabolic burden similar to Cushing Syndrome, even without typical f...
A new study led by Boston Medical Center researchers shows that Black individuals who were incarcerated have a statistically significant 65% increase in mortality rates compared to non-Hispanic non-Black individuals. This finding highlights the long-term impacts of incarceration on health, particularly among marginalized communities.
A recent study published in the American Journal of Respiratory and Critical Care Medicine found that using race-based equations to evaluate lung disease can lead to under-treatment of Black patients. The research, conducted by a team at the University of California - San Francisco, used data from SPIROMICS, a multi-center cohort of ev...
Researchers found that adapted D-dimer thresholds are safe and efficient for ruling out acute pulmonary embolism, even in high-risk patient subgroups. Strategies with adapted thresholds have up to 3-fold increased efficiency, but also higher predicted failure rates.
A cohort study of 165 patients with hepatitis C-related hepatocellular carcinoma found that treating the virus with direct-acting antivirals reduces tumor progression and metastasis. The study showed a 72% reduction in tumor progression and an 88% reduction in risk of death from HCC.
A new study found that only alcohol consumption consistently triggers episodes of atrial fibrillation, a common heart condition. The study used an individualized testing method, where participants tested various triggers, including drinking alcohol and caffeine, to find the most effective ways to manage their AF.
Experts suggest expanding treatment options for hospital patients with opioid withdrawal symptoms, potentially allowing more individualized and patient-centered care. Randomized controlled trials are needed to determine the efficacy of short-acting opioids in this context.
A modeling study found that annual mammography screening beyond age 75 may provide little to no benefit in terms of lives saved, while increasing costs and potential harms from overdiagnosis. Biennial screening up to age 80 is more cost-effective but yields a small number of deaths averted.
A review board comprising healthcare professionals from various disciplines has sharply reduced opioid prescribing at an OHSU internal medicine clinic. The clinic uses a systematic approach to review high-risk cases and coach primary care providers on tapering patients off opioids.
The article highlights the importance of recovering routine vaccination rates after the COVID-19 pandemic. Vaccinations for MMR, DTaP, polio, and HPV have seen significant drops, posing dire consequences to population health. Experts emphasize the need for stakeholders to drive awareness, facilitate access, and build vaccine confidence.
A study published in Nature Communications identified C-terminal binding protein 2 (CtBP2) as a global regulator of metabolism that balances sugar and fat levels in the liver. CtBP2 is crucial for controlling glucose and lipid balance, making it a promising drug target for treating symptoms associated with obesity.
A randomized controlled trial found that CBT with yoga and education components significantly reduced pain impact and disability in patients on long-term opioid therapy. Patients receiving CBT also reported greater reductions in pain compared to those receiving usual care.
A recent study published in JAMA Internal Medicine investigated the incidence of cerebral venous sinus thrombosis (CVST) after post-vaccination. The researchers found that the rate of this rare adverse effect is significantly higher than pre-pandemic rates, prompting consideration of vaccine effectiveness in preventing COVID-19.
Researchers found that certain urinary biomarkers, including neutrophil gelatinase-associated lipocalin and kidney injury molecule-1, were associated with increased risk of severe acute kidney injury or death in patients hospitalized with COVID-19. These biomarkers may help identify patients at high risk for adverse kidney outcomes.
A recent study by Cedars-Sinai Medical Center found that COVID-19 mRNA vaccines induced detectable antibodies in 99% of patients with bowel disease, regardless of their immunocompromising therapies. Researchers also noted a correlation between the antibody response and effective immunity in the community.
A study of 9,739 adults found that those with stable overweight and obesity had elevated cardiac troponin I levels, a marker of subclinical heart injury. Long-standing obesity is associated with injurious effects on cardiac health before symptoms occur.
Researchers have discovered three new genetic variants linked to fibromuscular dysplasia, which affects women in their prime and is often associated with high blood pressure and cardiovascular complications. The study provides new insights into the disease's genetic basis and potential therapeutic targets.
A recent review published in the Journal of the American Heart Association found that flu vaccination can significantly reduce the risk of heart attack and stroke in individuals with heart disease. Despite higher mortality rates from influenza, many Americans under 65 with heart disease have low vaccination rates.
A plasma biomarker panel identified a combination of sTNFR1, sTNFR2, cystatin C, and eGFR that discriminated between patients with worsening or low risk of chronic kidney disease after three years. This combination was particularly effective at identifying those with very low risk of subsequent kidney dysfunction.
The National Kidney Foundation has released a research roadmap to accelerate innovations in treatment and increase understanding of kidney disease. The report calls for increased funding in preclinical science, genetics, health equity, and implementation science to tackle the most vexing challenges in kidney disease.
Patients with strong antibody responses against SARS-CoV-2 had low viral RNA levels and survived the illness. The study supports personalized treatment with exogenous antibodies for those with absent or low endogenous antibodies levels.
Researchers investigated whether hospital admission and discharge are associated with increased risk of fatal drug overdoses. The study found that the first two days after hospital discharge is a critical moment for people who use illicit opioids.
A large observational study found statin use associated with faster diabetes progression in patients with diabetes. The study included 83,000 matched pairs and followed them for an average of 2 years.
A population-based study of 2.4 million people found rare cases of acute myocarditis after COVID-19 mRNA vaccination in young men. The study suggests that the signal of increased myocarditis warrants further investigation into the relationship between COVID-19 vaccines and cardiac complications.
Researchers propose reinstating waiting time for recipients experiencing early post-transplant allograft failure within an expanded timeframe to boost transplant numbers. This policy change could potentially reduce the perceived patient-level risk of transplanting marginal organs and improve organ utilization.
A serum biomarker, polyubiquitinated phosphatase and tensin homolog (PTEN), was associated with a four-fold higher risk of kidney function decline. This modified form of PTEN was linked to severity of lesions in kidney structure, indicating early manifestations of diabetic kidney disease.