Articles tagged with Internal Medicine
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 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.
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.
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.
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.
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.
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.
Researchers have developed a novel strategy to treat, prevent, and possibly reverse liver damages by exploiting small extracellular vesicles derived from interferon-γ pre-conditioned MSCs. The approach has shown promising results in reducing inflammation and fibrosis in a mouse model of cirrhosis.
During the COVID-19 pandemic, there was a significant shift in internal medicine residency and fellowship applications. The study found that the number of applicants and applications submitted per applicant decreased in 2021 compared to previous years.
The new online-only journal aims to share valuable lessons from clinicians' discussions on challenging cases, contributing to medical innovation and improved care. The digital, peer-reviewed journal will publish bi-monthly issues initially and become more frequent over time.
Researchers from NIH propose a new method to estimate vaccine efficacy by following original placebo recipients after vaccination, allowing assessment of durability and potential delayed harm. This approach enables timely access to the vaccine for placebo recipients while maintaining unbiased estimates.
A nationally representative survey found that over 40% of US adults aged 50-80 trust online reviews almost as much as family or friend recommendations when selecting a physician. Factors such as insurance acceptance and race/ethnicity were more influential, with online reviews ranking ninth in importance.
Case report describes two patients who underwent a successful second dose of the Moderna vaccine using a graded dosing protocol after experiencing immediate hypersensitivity reactions. Both patients responded well and developed IgG antibodies, suggesting effective vaccination despite the modified dosing schedule.
Vaccinating healthcare workers reduced positive COVID-19 cases by over 90%, with infection rates lowest among fully vaccinated employees, according to data from UT Southwestern Medical Center. The institution saw a significant reduction in required isolations and quarantines.
A Zika virus candidate, Ad26.ZIKV.001, showed promising safety and immunogenicity in a phase I clinical trial. The vaccine induced persistent neutralizing antibody responses and was found to be safe with mild to moderate reactogenicity. Researchers recommend further development of the vaccine should the need reemerge.
The Advisory Committee on Immunization Practices (ACIP) has released its 2021 Recommended Adult Immunization Schedule, which includes interim recommendations for COVID-19 vaccination. The updated schedule features revised content and harmonized changes with the Child and Adolescent Immunization Schedule.
The American College of Physicians (ACP) has updated its practice points on the use of remdesivir in treating hospitalized COVID-19 patients. The new guidelines aim to target patients who are most likely to benefit from treatment, recommending a duration of treatment based on symptom duration and disease severity. According to the upda...
The American College of Physicians and Annals of Internal Medicine hosted a third virtual COVID-19 vaccine forum, discussing the allocation and distribution of available vaccines. Researchers also published an observational study finding that early therapeutic anticoagulation in critically ill patients with COVID-19 did not affect surv...
A review of 61 studies confirms that at least 1 in 3 people infected with SARS-CoV-2 do not exhibit symptoms, suggesting widespread testing can help identify asymptomatic spreaders. The findings also underscore the importance of determining vaccine effectiveness against asymptomatic infections.
A recent study found that mortality rates decreased among critically ill COVID-19 patients over time. In contrast, experts from NIAID emphasized the importance of using data to encourage vaccine uptake. Meanwhile, a hospital essay describes a Ransomware attack during the pandemic, highlighting the challenges faced by healthcare profess...
The American College of Physicians (ACP) has released a comprehensive framework to address disparities and discrimination in healthcare, proposing policy recommendations to enhance quality and effectiveness for all patients. The framework also discusses specific contributors to health disparities and steps to improve them.
A recent study found that 85.9% of COVID-19 patients with mild cases experienced olfactory dysfunction, lasting an average of 21.6 days. Nearly one-quarter of patients did not recover their sense of smell 60 days after losing it.
Researchers suggest that single-dose vaccines may offer greater population benefit due to the speed-versus-efficacy tradeoff. Alternative dose allocation strategies also improve benefits by vaccinating more people sooner while maintaining scheduling for second doses.
A study from Cedars-Sinai Medical Center found that people who move due to unaffordable housing are at increased risk of failing to receive necessary medical care, leading to long-term health problems. The research highlights the need for preventive action to mitigate the adverse effects of cost-related moves on healthcare access.
The American College of Physicians (ACP) hosted a virtual COVID-19 Vaccine Forum II to address barriers to optimal vaccine uptake. Panelists emphasized the need for comprehensive public health communications campaigns to refute misinformation and build trust among disproportionately affected minority communities.
A recent study found that combining mandatory mask-wearing policies with extensive social distancing can prevent most COVID-19 cases on college campuses, with routine testing also showing high effectiveness. However, the cost of testing may be a barrier for some colleges and universities.
A national survey of 4,000 adults found that fewer than 10% have ever discussed firearm safety with a clinician, highlighting the need for improvement in clinical settings. The study also found that when conversations occurred, the most common advice given was to lock all household firearms.
A new study by Michigan Medicine researchers found that pulse oximeter readings may be less accurate in Black patients than in White patients, leading to potential mismanagement of treatment. The findings suggest that device makers may need to make changes to ensure accurate readings for all patients.
A systematic review published in Annals of Internal Medicine confirms health disparities in COVID-19 outcomes among Black and Hispanic populations, attributing the disparity to increased risk of exposure and transmission. The study highlights the need for targeted efforts to reduce exposure to the virus in vulnerable populations.
A systematic review of COVID-19 data in the US reveals disproportionately higher rates of infection and mortality among African American/Black and Hispanic populations. The authors call for urgent interventions to mitigate these disparities. Read the full text to learn more about the findings.
The study found that adults in states voting for Hillary Clinton experienced 54.6 million more days of poor mental health, compared to Trump-voting states, with increases observed in older adults, women, and white individuals. Depression rates also rose in Clinton-voting states after the election.
An agent-based computer model shows that delayed implementation of social distancing measures and low adherence can increase COVID-19 cases in urban areas. Maintaining personal behaviors like face mask use after easing social distancing measures also has a significant impact.
Two new UT Southwestern studies report that only half of practicing physicians are registered to vote, with time being the most common barrier faced by resident physicians. The researchers say finding ways to increase voter participation among doctors is critical as the nation tackles healthcare issues.
Industry, government, and academic researchers propose general clinical endpoints to facilitate evaluation of COVID-19 vaccine candidates. These endpoints include asymptomatic infection as a study endpoint.
The American College of Physicians (ACP) and Annals of Internal Medicine hosted a virtual forum on October 16, assembling leading health experts to discuss timely information related to COVID-19 vaccines. Panelists offered current evidence-based insights into vaccine science, approval processes, and clinical recommendations.
Researchers found that 12.1% of cases received out-of-network claims, often due to out-of-network anesthesiologists and pathologists. The study suggests partnering with in-network providers and considering cost-saving strategies to spare patients surprise bills.