Articles tagged with Internal Medicine
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.
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.
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 recent study has found that pregnancies complicated by sepsis are associated with a higher risk of cesarean delivery, postpartum hemorrhage, and preterm delivery. Researchers recommend increased prenatal surveillance for patients with sepsis and other serious infections to mitigate these risks.
A new study by the University of California, San Francisco found that consuming even one alcoholic drink can significantly increase the risk of atrial fibrillation. The research involved tracking 100 patients with documented AF and found that those who consumed more alcohol had higher odds of experiencing an AF episode.
A telephone-delivered nursing care strategy combining heart failure care management with depression treatment improved patients' clinical outcomes. Patients receiving 'blended' collaborative care showed better mental health-related quality of life, including improved mood and reduced limitations in social activities.
A prospective cohort study found that nearly 90% of immunocompromised patients developed an antibody response to SARS-CoV-2 vaccination, suggesting potential protection against severe illness. The response was weaker than in healthy participants but still encouraging for immunocompromised individuals.
Referral guidelines for nephrology care are shifting towards identifying patients at higher risk of kidney failure. A study using Veterans Health Administration data found that referring patients with a two-year risk of kidney failure above 1% would identify those at highest median risk.
A randomized trial found that a shorter course of rifapentine-isoniazid therapy resulted in significantly higher treatment completion rates compared to a longer daily course. The findings suggest that this regimens can be more effective for preventing tuberculosis disease in individuals with HIV, particularly in high-transmission areas.
A Korean population-based cohort study found that cancer, particularly multiple myeloma and leukemia, is associated with an increased risk of kidney failure. The study included approximately 825,000 patients with cancer compared to twice as many without cancer, matched on other characteristics.
Ongoing acute kidney injury in deceased donor kidneys is linked to lower long-term graft survival. Notably, abnormal serum creatinine values during procurement also negatively impact graft outcomes.
This observational study found no association between prenatal antipsychotic exposure and increased risk of preterm birth, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder in children. The study's findings suggest that antipsychotics during pregnancy do not pose a significant risk to fetal development.
Researchers from Osaka University found that quercetin in buckwheat liquor induces autophagy, a process that cleans up damaged proteins, and aggrephagy, which removes protein aggregates. This could lead to new treatments for diseases like Alzheimer's and alcoholic liver disease.
A study found that mRNA vaccine recipients with prior SARS-CoV-2 infection experienced more severe symptoms after vaccination. The study suggests vaccine type may influence symptom severity in individuals with a history of COVID-19 infection.
A multicenter randomized trial showed acupuncture improved symptoms of moderate to severe CP/CPPS, with effects lasting over 24 weeks. Acupuncture was more effective than sham therapy in reducing symptoms and improving quality of life for men with chronic prostatitis/chronic pelvic pain syndrome.
A multicenter cohort study found that incomplete polyp removal is strongly associated with postcolonoscopy colorectal cancer. Researchers analyzed medical records for 233 participants and found that patients with incompletely removed polyps were more likely to develop metachronous neoplasia, including advanced tumors.
Rates of COVID-19 hospitalizations, ICU admissions, and in-hospital deaths peaked in December 2020 among adults aged 65+, males, and Hispanic or non-Hispanic Black persons. Effective therapeutics use increased while invasive interventions waned, suggesting clinical practice evolved based on increasing knowledge.
Researchers investigated the link between state opioid prescription duration limits and changes in opioid prescribing. The study found that limiting initial opioid prescriptions may lead to a decrease in opioid-related overdose deaths, but also increase unnecessary hospitalizations.
A large study found that COVID-19 infection during pregnancy is associated with a higher risk of very preterm birth and all preterm births. People of color face disproportionate infection risk while pregnant. Researchers recommend vaccination to reduce COVID-19 infection and prevent preterm birth.
The study found COVID-19 incidence was significantly higher in Massachusetts prisons operating at a higher percentage of their capacity. In contrast, prisons with more single-cell housing had lower infection rates.
A research team from Brigham and Women's Hospital found that delivering acute care at home for non-COVID patients freed up substantial inpatient capacity during the COVID-19 surge. The Home Hospital program provided care for 65 acutely ill patients, amounting to 419 bed-days, over a 3-month period.
Researchers analyzed 1.95 million family units, finding a low overall rate of misattributed paternity (1.7%) with rates closer to 1% in recent decades. The study's findings suggest that misattributed paternity is unlikely to have significant effects on hereditary condition studies.
A recent study in Annals of Internal Medicine suggests that mandatory COVID-19 vaccination for healthcare workers is strongly justified due to the higher mortality rate of SARS-CoV-2 compared to influenza. The authors propose strategies to increase employee acceptance and overcome vaccine hesitancy, emphasizing the importance of protec...
Researchers found that general internal medicine and family medicine clinicians spent an average of two hours actively using the EHR each day, while pediatricians spent around one hour and a half. The study suggests improvements in messaging and placing orders could reduce burnout among primary care clinicians.
A retrospective cohort study found that COVID-19 surges in hardest-hit US hospitals doubled mortality rates. Researchers also discovered that nearly a third of persons with mild to moderate COVID-19 experience lingering symptoms months after infection.
The ACTIV (Accelerating COVID-19 Therapeutic Interventions and Vaccines) workgroup has developed nine master protocols to evaluate therapeutic agents for COVID-19. The protocols aim to accelerate drug development and improve treatment outcomes for patients with COVID-19.
A FDA advisory panelist outlines numerous issues with aducanumab's accelerated approval for Alzheimer's disease, including uncertainty regarding its clinical benefits and safety. The approval may lead to a substantial financial burden on American families due to the already substantial cost of the disease.
A recent commentary published in Annals of Internal Medicine highlights the growing concern of rhino-orbito-cerebral mucormycosis, or 'black fungus', in India. Experts recommend nonpharmacological measures and careful corticosteroid use to prevent and manage this syndemic.
A modeling study found that schools can reopen safely with controlled community transmission and moderate mitigation strategies in place. Asymptomatic screening is one identified strategy to facilitate reopening while minimizing transmission risk.
A retrospective cohort study found that autonomous cortisol secretion is associated with a 2- to 3-fold increased risk of death and cardiovascular disease in patients with adrenal incidentalomas. Researchers recommend treating known cardiovascular risk factors and incorporating findings into treatment decisions, including surgery.
Preoperative testing is often unnecessary for low-risk surgeries, yet it continues to be ordered despite evidence suggesting its low value. Patients who had a complete medical history and physical done during a visit were more likely to have had preoperative testing.
Point-of-care ultrasonography significantly improves diagnostic accuracy in patients with acute dyspnea, allowing for quicker diagnosis and treatment initiation. The technology involves mobile ultrasound devices that enable rapid scanning of multiple organs, including lungs, hearts, and leg veins.
A large US health care database study suggests that pregnant patients with COVID-19 have a lower rate of in-hospital death compared to non-pregnant women. The study revealed that pregnant patients were less likely to have comorbid conditions, resulting in a substantially lower mortality rate.
A new commentary suggests that more extensive use of minimally invasive non-endoscopic tests for Barrett's esophagus (BE) screening could lead to better early detection and prevention of esophageal adenocarcinoma, a deadly form of cancer. BE is often asymptomatic, but endoscopic treatment can reduce the risk of progression to cancer.