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Displaying 441 - 450 of 7510 in ACP Online
Reflections on Practice Transformation
Watch ACP members describe their experiences and successes with preparing their practices for value-based payment. These videos explore topics as diverse as the unique role internists play in practice transformation, the shift to value-based care, the importance of patient engagement, and resources ACP has to assist with transformation. Success Story: Strategies to Reduce Inappropriate Antibiotic Prescribing, featuring Rebecca Andrews, MD, FACP
Practice Transformation
Payment reform and the rapid transition to telehealth is forcing medical practices to transform many aspects of how they deliver care.
Patient and Family Engagement (PFE) Webinar Series Recordings
This three-part webinar series on key PFE topics, including health literacy, collaborative medication management, and patient and family engagement, was developed as a collaboration between the ACP SAN and the Institute for Patient- and Family-Centered Care (IPFCC). [block:block=88]
ACP SAN Clinical Webinar Series Recordings
This four-part webinar series on key clinical topics, including diabetes, hypertension, and opioid management, was developed by the ACP Support and Alignment Network to promote several new or newly updated ACP Practice Advisor modules.
Private Payers
ACP provides a wealth of resources and guides on coding for and getting paid by commercial payers.
How to Bill Medicare’s Annual Wellness Visit | ACP
Visit ACP for information on how to bill Medicare's Annual Wellness Visit (AWV) and to access a Practice Checklist, Patient Letter & Checklist, and more.
Displaying 441 - 450 of 6736 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.
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Mammography Screening Preferences Among Screening-Eligible Women in Their 40s: A National U.S. Survey: Annals of Internal Medicine: Vol 177, No 8
Background: The U.S. Preventive Services Task Force (USPSTF) recently changed its recommendation for mammography screening from informed decision making to biennial screening for women aged 40 to 49 years. Although many women welcome this change, some may prefer not to be screened at age 40 years. Objective: To conduct a national probability-based U.S. survey to investigate breast cancer screening preferences among women aged 39 to 49 years. Design: Pre–post survey with a breast cancer screening decision aid (DA) intervention. (ClinicalTrials.gov: NCT05376241) Setting: Online national U.S. survey. Participants: 495 women aged 39 to 49 years without a history of breast cancer or a known BRCA1/2 gene mutation. Intervention: A mammography screening DA providing information about screening benefits and harms and a personalized breast cancer risk estimate. Measurements: Screening preferences (assessed before and after the DA), 10-year Gail model risk estimate, and whether the information was surprising and different from past messages. Results: Before viewing the DA, 27.0% of participants preferred to delay screening (vs. having mammography at their current age), compared with 38.5% after the DA. There was no increase in the number never wanting mammography (5.4% before the DA vs. 4.3% after the DA). Participants who preferred to delay screening had lower breast cancer risk than those who preferred not to delay. The information about overdiagnosis was surprising for 37.4% of participants versus 27.2% and 22.9% for information about false-positive results and screening benefits, respectively. Limitation: Respondent preferences may have been influenced by the then-current USPSTF guideline. Conclusion: There are women in their 40s who would prefer to have mammography at an older age, especially after being informed of the benefits and harms of screening. Women who wanted to delay screening were at lower breast cancer risk than women who wanted screening at their current age. Many found information about the benefits and harms of mammography surprising. Primary Funding Source: National Cancer Institute.
Efficacy of Voluntary Medical Male Circumcision to Prevent HIV Infection Among Men Who Have Sex With Men: A Randomized Controlled Trial: Annals of Internal Medicine: Vol 177, No 6
Background: Observational studies suggest that voluntary medical male circumcision (VMMC) may lower HIV risk among men who have sex with men (MSM). A randomized controlled trial (RCT) is needed to confirm this. Objective: To assess the efficacy of VMMC in preventing incident HIV infection among MSM. Design: An RCT with up to 12 months of follow-up. (Chinese Clinical Trial Registry: ChiCTR2000039436) Setting: 8 cities in China. Participants: Uncircumcised, HIV-seronegative men aged 18 to 49 years who self-reported predominantly practicing insertive anal intercourse and had 2 or more male sex partners in the past 6 months. Intervention: VMMC. Measurements: Rapid testing for HIV was done at baseline and at 3, 6, 9, and 12 months. Behavioral questionnaires and other tests for sexually transmitted infections were done at baseline, 6 months, and 12 months. The primary outcome was HIV seroconversion using an intention-to-treat analysis. Results: The study enrolled 124 men in the intervention group and 123 in the control group, who contributed 120.7 and 123.1 person-years of observation, respectively. There were 0 seroconversions in the intervention group (0 infections [95% CI, 0.0 to 3.1 infections] per 100 person-years) and 5 seroconversions in the control group (4.1 infections [CI, 1.3 to 9.5 infections] per 100 person-years). The HIV hazard ratio was 0.09 (CI, 0.00 to 0.81; P = 0.029), and the HIV incidence was lower in the intervention group (log-rank P = 0.025). The incidence rates of syphilis, herpes simplex virus type 2, and penile human papillomavirus were not statistically significantly different between the 2 groups. There was no evidence of HIV risk compensation. Limitation: Few HIV seroconversions and limited follow-up period. Conclusion: Among MSM who predominantly practice insertive anal intercourse, VMMC is efficacious in preventing incident HIV infection; MSM should be included in VMMC guidelines. Primary Funding Source: The National Science and Technology Major Project of China.
Reporting Conflicts of Interest and Funding in Health Care Guidelines: The RIGHT-COI&F Checklist
Background: Conflicts of interest (COIs) of contributors to a guideline project and the funding of that project can influence the development of the guideline. Comprehensive reporting of information on COIs and funding is essential for the transparency and credibility of guidelines. Objective: To develop an extension of the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement for the reporting of COIs and funding in policy documents of guideline organizations and in guidelines: the RIGHT-COI&F checklist. Design: The recommendations of the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network were followed. The process consisted of registration of the project and setting up working groups, generation of the initial list of items, achieving consensus on the items, and formulating and testing the final checklist. Setting: International collaboration. Participants: 44 experts. Measurements: Consensus on checklist items. Results: The checklist contains 27 items: 18 about the COIs of contributors and 9 about the funding of the guideline project. Of the 27 items, 16 are labeled as policy related because they address the reporting of COI and funding policies that apply across an organization’s guideline projects. These items should be described ideally in the organization’s policy documents, otherwise in the specific guideline. The remaining 11 items are labeled as implementation related and they address the reporting of COIs and funding of the specific guideline. Limitation: The RIGHT-COI&F checklist requires testing in real-life use. Conclusion: The RIGHT-COI&F checklist can be used to guide the reporting of COIs and funding in guideline development and to assess the completeness of reporting in published guidelines and policy documents. Primary Funding Source: The Fundamental Research Funds for the Central Universities of China.
Displaying 441 - 450 of 4549 in IM Matters
Displaying 441 - 450 of 2336 in ACP Hospitalist
Displaying 441 - 450 of 500 in Annals of Internal Medicine: Clinical Cases
Wernicke Encephalopathy After Sleeve Gastrectomy | Annals of Internal Medicine: Clinical Cases
We present a case of Wernicke encephalopathy after sleeve gastrectomy. The patient exhibited spontaneous upbeat nystagmus and gaze-evoked nystagmus during an ophthalmologic examination, as shown in the accompanying video. High-dose thiamine therapy resulted in significant improvement in the patient's dizziness and nystagmus.
Sexually Transmitted Ischemia, the Other STI: A Case of Gonococcal Endocarditis With Acute Limb Ischemia | Annals of Internal Medicine: Clinical Cases
A 52-year-old man developed acute pain, numbness, and weakness of his right leg with prodromal fevers and arthralgias. Evaluation revealed mitral valve vegetation and a right femoral artery occlusion, alleviated with thromboembolectomy. Blood cultures finalized without growth, but the thrombus culture grew Neisseria gonorrhea. He was diagnosed with acute limb ischemia due to septic embolization from infective endocarditis. Gonococcal endocarditis occurs in a fraction of disseminated gonococcal infection cases. This pathogen is difficult to culture, complicating diagnosis. Embolic cultures are a valuable tool in identifying gonococcal endocarditis and should be considered in cases of culture-negative endocarditis with septic embolization.
Bilateral Facial Nerve Palsy After Weekly Nanoparticle Albumin–Bound Paclitaxel Treatment in Pancreatic Cancer | Annals of Internal Medicine: Clinical Cases
Peripheral neuropathy is a common side effect of microtubule inhibitors. Rare cases of cranial nerve palsies have been reported with paclitaxel and 1 case of unilateral facial nerve palsy has been reported with nanoparticle albumin-bound paclitaxel (nab-ptx). We report a rare case of bilateral facial nerve palsy from nab-ptx.
Unusual Case of Hypereosinophilia in Hodgkin Lymphoma in a Nigerian Woman | Annals of Internal Medicine: Clinical Cases
Hodgkin lymphoma (HL) is characterized by Reed–Sternberg cells. Eosinophilia is an expected finding in patients with HL. However, there are few reports of hypereosinophilia in HL. We report a 45-year-old woman with fever, lymphadenopathy, and abdominal distention. Her complete blood count at presentation showed a total leukocyte count of 60 800 cells/mm3 with an eosinophil count of 46 000 cells/mm3. Lymph node biopsy revealed lymphocyte-rich HL, with eosinophil count dropping to 90 cells/mm3 after chemotherapy. Hypereosinophilia is unusual and needs to be extensively investigated. In HL, hypereosinophilia is thought to occur from cytokine secretion by Reed–Steinberg cells.
Hypertension and Headache in the Setting of Vertebral and Carotid Fibromuscular Dysplasia | Annals of Internal Medicine: Clinical Cases
A 98-year-old woman presented in the context of headache and was found to have evidence of a beaded appearance of the bilateral carotid and vertebral arteries. Fibromuscular dysplasia of the carotid and vertebral arteries is rare but may present with symptoms of headache, dizziness, transient ischemic attack, or stroke. Management of symptomatic patients focuses on the use of antihypertensive drugs and secondary prevention with antiplatelet agents. Surgical intervention is referred for those cases that are nonresponsive to the aforementioned treatments.
An Image Case of Lepromatous Leprosy in a Patient With Parkinson Disease | Annals of Internal Medicine: Clinical Cases
A 72-year-old man with Parkinson disease presented with 18 months of diffuse blotchiness without associated pain or pruritis. Fite stain and Mycobacterium leprae polymerase chain reaction of a skin biopsy specimen were positive, and he was diagnosed with lepromatous leprosy.
A Rare Case of Disseminated Coccidioidomycosis Presenting as an Intracardiac Mass | Annals of Internal Medicine: Clinical Cases
A 26-year-old immunocompetent male with a history of disseminated coccidioidomycosis presented with shortness of breath for 2 weeks. Computed tomography showed a right paratracheal mass that extended into and compressed the right ventricle. Transthoracic echocardiogram confirmed the presence of a large homogenous mass. Biopsy results revealed granulomatous inflammation with numerous organisms, consistent with Coccidioides. Despite treatment with antifungal therapy, the patient expired due to hemodynamic decline. Extrapulmonary involvement of Coccidioides is rare and is associated with significant morbidity and mortality. Even with completed treatment, the rate of relapse is high, necessitating regular follow up, drug resistance testing, and the monitoring of complement fixation titers.