Search Results for ""
- ACP Online (7462)
- Annals of Internal Medicine (6915)
- ACP Store (242)
- IM Matters (3160)
- ACP Hospitalist (2455)
- Annals of Internal Medicine: Clinical Cases (499)
Displaying 401 - 410 of 7462 in ACP Online
Independent Practice Resources
ACP helps medical practices with the business side of medicine. Learn about our medical practice management resources here.
Tech Tips and Support for Peer Coaching Programs
General Requirements The program is delivered via an online platform. You will log into the platform using your first and last name and the email address you used when registering (your ACP account email—see https://www.acponline.org/myacp to check if you aren’t sure which email address is your primary on your ACP account).
Physician Coaching & Training Program | Peer Coaching
Train in evidence-based coaching techniques through ACP’s peer coaching program to support colleagues, boost well-being, and earn CME credit.
What to Expect from Coaching
What can you expect from your coaching session? Your coach will help you define the area of focus for your session, explore what success looks like within that area, and identify the potential ways to move forward. You will be provided with a safe space where you will be listened to and have time to organize your thoughts. Your coach will offer reflections and ask questions to help you find the answers.
Individual and Group Coaching Services
ACP’s Physician Peer Coaching program offers a suite of program offerings to provide you with ongoing support to help you thrive personally and professionally.
Group Coaching Sessions
ACP has designed a series of 1-hr group coaching sessions to support your career and professional development. During each session, you and up to 5 of your peers will work with an ACP Physician Peer coach on the following topics. Navigating Career Transitions as a Mid-Career PhysicianTuesday, June 16, 2026, 12:00-1:00pm ESTThis one-hour group coaching session for mid-career physicians is focused on helping you set your career goals and creating an action plan to take the next step in your career.
Get to Know Your ACP Physician Peer Coaches
Bisi Alli, DO, MS, DipABLM, FACP, FAMWAWellNEST Medicine LLCPhoenix, AZAll settingsEarly-Mid-CareerLinkedIn Link
Meet Your Lead Coach: Kerri Palamara, MD, MACP
Kerri Palamara, MD, MACP — LOCATION — Boston, MA (Massachusetts General Hospital) — PRACTICE TYPE — Outpatient — CAREER LEVEL — Mid-career
ACP Physician Peer Coaching Program Rules
Coach Training ProgramEligibility:Participants must be an active physician member in good standing to be eligible to participate in this program. Active membership is required throughout the term of the program. If the participant’s membership expires during the program term, they will be required to renew their membership to continue accessing online materials. Residents, Fellows-in-Training, and Medical Students are not eligible for this program.Attendance:
ACP Physician Peer Coach Training Workshops
ACP Physician Peer Coach Training virtual workshops help you leverage evidence-based coaching skills to support your professional development and fulfillment.Upcoming WorkshopsBuilding a Coaching Culture at Your InstitutionThis 4-hour ACP Physician Peer Coach Training virtual workshop, led by Kerri Palamara, MD, MACP, will provide exclusive training on how to create a coaching culture at your institution. Designed for individuals with prior coaching experience and want to build a coaching program at their institution.The workshop focuses on:
Displaying 401 - 410 of 6915 in Annals of Internal Medicine
These Annals of Internal Medicine results only contain recent articles.
- Visit annals.org to search all content back to 1927.
- View Annals of Internal Medicine CME by topic here.
Morbidity and Mortality of Hospital-Onset SARS-CoV-2 Infections Due to Omicron Versus Prior Variants: A Propensity-Matched Analysis: Annals of Internal Medicine: Vol 177, No 8
Background: Many hospitals have scaled back measures to prevent nosocomial SARS-CoV-2 infection given large decreases in the morbidity and mortality of SARS-CoV-2 infections for most people. Little is known, however, about the morbidity and mortality of nosocomial SARS-CoV-2 infections for hospitalized patients in the Omicron era. Objective: To estimate the effect of nosocomial SARS-CoV-2 infection on hospitalized patients’ outcomes during the pre-Omicron and Omicron periods. Design: Retrospective matched cohort study. Setting: 5 acute care hospitals in Massachusetts, December 2020 to April 2023. Patients: Adults testing positive for SARS-CoV-2 on or after hospital day 5, after negative SARS-CoV-2 test results on admission and on hospital day 3, were matched to control participants by hospital, service, time period, days since admission, and propensity scores that incorporated demographics, comorbid conditions, vaccination status, primary diagnosis category, vital signs, and laboratory test values. Measurements: Primary outcomes were hospital mortality and time to discharge. Secondary outcomes were intensive care unit (ICU) admission, need for advanced oxygen support, discharge destination, hospital-free days, and 30-day readmissions. Results: There were 274 cases of hospital-onset SARS-CoV-2 infection during the pre-Omicron period and 1037 cases during the Omicron period (0.17 vs. 0.49 cases per 100 admissions). Patients with hospital-onset SARS-CoV-2 infection were older and had more comorbid conditions than those without. During the pre-Omicron period, hospital-onset SARS-CoV-2 infection was associated with increased risk for ICU admission, increased need for high-flow oxygen, longer time to discharge (median difference, 4.7 days [95% CI, 2.9 to 6.6 days]), and higher mortality (risk ratio, 2.0 [CI, 1.1 to 3.8]) versus matched control participants. During the Omicron period, hospital-onset SARS-CoV-2 infection remained associated with increased risk for ICU admission and increased time to discharge (median difference, 4.2 days [CI, 3.6 to 5.0 days]). The association with increased hospital mortality was attenuated but still significant (risk ratio, 1.6 [CI, 1.2 to 2.3]). Limitation: Residual confounding may be present. Conclusion: Hospital-onset SARS-CoV-2 infection during the Omicron period remains associated with increased morbidity and mortality. Primary Funding Source: Harvard Medical School Department of Population Medicine.
Trends in Diet Quality Among U.S. Adults From 1999 to 2020 by Race, Ethnicity, and Socioeconomic Disadvantage
Background: Few data have assessed trends in diet quality among U.S. adults. Objective: To evaluate trends in diet quality by race, ethnicity, and socioeconomic disadvantage. Design: Repeated cross-sectional study. Setting: United States. Participants: Noninstitutionalized adults aged 20 years or older who responded to the 1999–2020 National Health and Nutrition Examination Survey (NHANES). Measurements: The proportion of participants meeting the targets of the validated American Heart Association (AHA) 2020 continuous diet score (based on higher intake of fruits, vegetables, whole grains, fish and shellfish, and nuts, seeds, and legumes and lower intake of sugar-sweetened beverages, processed meat, saturated fat, and sodium) and the Healthy Eating Index (HEI)-2015, and energy-adjusted consumption of their components and other individual food groups and nutrients. Poor diet was defined as less than 40% adherence to the AHA score, intermediate as 40% to 79.9% adherence, and ideal as at least 80% adherence. Results: A total of 51 703 adults were included. From 1999 to 2020, the proportion of U.S. adults with poor diet quality decreased from 48.8% to 37.4% (difference, −11.4 percentage points [95% CI, −16.8 to −5.96 percentage points]), the proportion with intermediate quality increased from 50.6% to 61.1% (difference, 10.5 percentage points [CI, 5.20 to 16.1 percentage points]), and the proportion with ideal quality increased from 0.66% to 1.58% (difference, 0.93 percentage points [CI, 0.35 to 1.51 percentage points]) (P for trend < 0.001 for each). Persistent or worsening disparities in diet quality were observed by age, sex, race and ethnicity, education, income, food security, Supplemental Nutrition Assistance Program participation, and health insurance coverage. For example, the proportion of adults with poor diet quality decreased from 47.9% to 33.0% among those with food security (P for trend < 0.001) but did not change (51.3% to 48.2%) among those experiencing food insecurity (P for trend = 0.140) (P for interaction = 0.001). Findings were similar for HEI-2015. Limitations: Self-reported diet; cross-sectional study design. Conclusion: Diet quality among U.S. adults improved modestly between 1999 and 2020, but the proportion with poor diet quality remains high, and dietary disparities persist or are worsening. Primary Funding Source: National Institutes of Health.
Comparative Effectiveness and Safety of Atorvastatin Versus Rosuvastatin: A Multi-database Cohort Study: Annals of Internal Medicine: Vol 177, No 12
Background: Rosuvastatin and atorvastatin are the most widely prescribed moderate- to high-intensity statins. However, evidence on their efficacy and safety during actual use is limited. Objective: To compare the real-world effectiveness and safety of rosuvastatin and atorvastatin. Design: Active comparator cohort study using target trial emulation. Setting: The China Renal Data System (CRDS) and UK Biobank (UKB) databases. Participants: Adults newly prescribed rosuvastatin or atorvastatin. Measurements: The primary outcome was all-cause mortality. Cox proportional hazards regressions were used after 1:1 multilevel propensity score matching. Results: Among the 285 680 eligible participants in both databases, 6-year all-cause mortality was lower for rosuvastatin than for atorvastatin (2.57 vs. 2.83 per 100 person-years in the CRDS database and 0.66 vs. 0.90 per 100 person-years in the UKB database), with differences in cumulative incidence of −1.03% (95% CI, −1.44% to −0.46%) in the CRDS database and −1.38% (CI, −2.50% to −0.21%) in the UKB database. For secondary outcomes in both databases, rosuvastatin conferred lower risks for major adverse cardiovascular events and major adverse liver outcomes. In the UKB database, the risk for development of type 2 diabetes mellitus was higher with rosuvastatin, and the 2 medications carried similar risks for development of chronic kidney disease and other statin-related adverse effects. Limitation: Possible residual confounding. Conclusion: This study found differences in risks for some important outcomes associated with rosuvastatin and atorvastatin. The differences were relatively small, and many did not meet traditional standards for statistical significance. Further research is needed to understand whether these findings can be used with confidence in clinical practice. Primary Funding Source: National Key R&D Program of China and National Natural Science Foundation of China.
Displaying 401 - 410 of 3160 in IM Matters
Displaying 401 - 410 of 2455 in ACP Hospitalist
Displaying 401 - 410 of 499 in Annals of Internal Medicine: Clinical Cases
Successful Peripartum Venoarterial Extracorporeal Membrane Oxygenation for Pheochromocytoma-Induced Cardiogenic Shock | Annals of Internal Medicine: Clinical Cases
We describe a 37-year-old multiparous woman with cardiogenic shock resulting from pheochromocytoma crisis. She had term labor induction after developing hypertension attributed to preeclampsia. Severe hemodynamic instability followed on postpartum day 2 requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO). Suspicion for pheochromocytoma arose after a computed tomography scan showed a large adrenal mass, and the diagnosis was confirmed with plasma and 24-hour urine metanephrine levels. She initially had cardiomyopathy with left ventricular ejection fraction less then 10%, which rapidly improved, and she was successfully weaned off VA-ECMO. This patient case illustrates the clinical challenges concerning pheochromocytoma during pregnancy.
IgG4-Related Disease Masquerading as Culture-Negative Endocarditis | Annals of Internal Medicine: Clinical Cases
We detail an extremely rare case of noninfective endocarditis secondary to IgG4-related disease on the mitral valve. A 75-year-old-woman with mitral valve ring annuloplasty presented with subacute, intermittent, self-limiting neurologic deficits. Magnetic resonance imaging of her brain revealed multiple small infarcts consistent with a cardioembolic phenomenon. Transesophageal echocardiogram revealed mobile, strand-like vegetations. She was taken for surgical repair of her mitral valve and tissue biopsy confirmed the diagnosis of IgG4-related disease. Our knowledge of this rare disease is continuously evolving, and this case highlights an exceptionally rare manifestation of this poorly understood disease.
Incidental Krukenberg Tumor During Cesarean Section | Annals of Internal Medicine: Clinical Cases
We present the case of a 29-year-old woman in her 30th week of pregnancy admitted for preterm contractions. She had an emergent cesarean delivery and was noted to have a large ovarian mass diagnosed on pathology as a Krukenberg tumor. Subsequent upper gastrointestinal endoscopy revealed gastric signet ring cell adenocarcinoma as the primary cancer. The patient received palliative chemotherapy and immunotherapy and is pending clinical trial participation. Pregnancy-associated gastric cancer is a rare condition with a poor prognosis as most symptoms may be attributed to a normal pregnancy. This misinterpretation often leads to a late diagnosis and poor outcomes.
Antibiotic and Surgical Treatment of a Ventriculoperitoneal Shunt-Related Soft Tissue Abscess Caused by Brucella melitensis | Annals of Internal Medicine: Clinical Cases
We report on the antibiotic and surgical treatment of a woman who presented with an abscess caused by Brucella melitensis related to a ventriculoperitoneal shunt, which is an atypical presentation of brucellosis. There were no signs of neurologic, osteoarticular, or peritoneal infection. The abscess initially healed after ultrasound-guided drainage and antibiotic treatment with gentamycin/doxycycline for 5 days, followed by doxycycline/ciprofloxacin for 8 weeks, allowing shunt preservation. Three months after treatment ended, however, a relapse occurred that required partial surgical shunt revision and readministration of antibiotics. Seven months after surgery and 12 months after the initial diagnosis, the patient's remission status has been maintained.
A Case Report of Postheart Transplant Epicardial Adipose Deposition in a Patient With Dunnigan Syndrome | Annals of Internal Medicine: Clinical Cases
Dunnigan syndrome is a rare genetic disorder that is a type of familial partial lipodystrophy. In some patients, severe cardiomyopathy and heart transplantation have been reported in this syndrome. Here, we describe a 40-year-old patient with Dunnigan syndrome who underwent heart transplantation for end-stage heart failure. Post-transplantation, routine imaging showed an accumulation of epicardial adipose tissue around the heart. In general, in Dunnigan syndrome, epicardial fat accumulation is not different compared with that of the general population. This is the first case report of exaggerated accumulation of adipose tissue around the heart causing subtle pericardial tamponade physiology.
Successful Extracorporeal Membrane Oxygenation After a Challenging Cannulation in a Pregnant Patient With COVID-19 | Annals of Internal Medicine: Clinical Cases
Veno-venous extracorporeal membrane oxygenation (V-V ECMO) support for fulminant COVID-19 pneumonia in a person with a viable pregnancy is controversial because many experts recommend delivery of the fetus before maternal ECMO. We describe V-V ECMO use for COVID-19 in a pregnant person at 28 weeks gestation. An inability to pass a guidewire from the jugular vein to the inferior vena cava complicated bedside ECMO cannulation, mandating a jugular-femoral 2-cannula approach that involves risk near a gravid uterus. In this case, procedural flexibility and multispecialty collaboration led to good maternal and fetal outcomes after 6 days of ECMO support.
Painless Neck Mass in a 47-Year-Old Man | Annals of Internal Medicine: Clinical Cases
A 47-year-old man presents for evaluation of a painless neck mass.
Refractory Premature Ventricular Complex Triggered Ventricular Fibrillation Responsive to Cardiac Sympathetic Denervation | Annals of Internal Medicine: Clinical Cases
A healthy 34-year-old woman sustained refractory idiopathic ventricular fibrillation (IVF) secondary to premature ventricular contractions (PVCs). Ischemic, structural, and genetic evaluations did not identify an attributable pathology. Here, we review the epidemiology, prognosis, and management of PVC-induced IVF. We additionally highlight the utility of cardiac sympathetic denervation.
A Sole Left Coronary Artery | Annals of Internal Medicine: Clinical Cases
Coronary artery anomalies are defined as coronary patterns that do not fit the usual origins and branching patterns from the ascending aorta. One such CAA includes a single coronary artery: a rare (often incidental) finding of only 1 coronary artery supplying the entire heart. This anomaly poses risks to the patient, with complications such as myocardial infarction and sudden cardiac death. Our patient case was a woman with high-risk coronary artery disease (CAD) who was incidentally found to have a single coronary artery. This is an important anatomical anomaly that can alter signs, symptoms, and subsequent treatment of patients with CAD.