Search Results for ""
- ACP Online (7611)
- Annals of Internal Medicine (6848)
- IM Matters (3141)
- ACP Hospitalist (2393)
- Annals of Internal Medicine: Clinical Cases (500)
- ACP Store (226)
Displaying 751 - 760 of 7611 in ACP Online
Future I.M. Experience Story Slam: Resilience During COVID-19
ACP asked trainees to explain how the COVID-19 pandemic affected their training. We are proud to present these inspiring stories. Resilience During COVID-19 William Butler - Bright Eyes During the Pandemic Florida State University College of Medicine
Providers’ Clinical Support System for Opioid Therapies
Through funding from the Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMSHA), ACP is collaborating with 12 other consortium partners to create and deliver resources to educate providers on practice-based approaches to improving chronic pain management and discussing tactics for implementing the best practices.
Point-of-Care Ultrasound Mentorship Program (POCUS) | ACP
Continue your point-of-care ultrasound learning and become more proficient in practice with this live, virtual course. Learn about POCUS training today.
Practical POCUS Skills for Internal Medicine Physicians
Unlock advanced POCUS skills for outpatient practice in internal medicine. Sign up today to get focused training, techniques, & insights in point-of-care ultrasound.
ACP Members Eligible for POCUS Mentorship Program
Contact information for ACP Members can be found in the Membership Directory.
Point of Care Ultrasound (POCUS) Training: Foundational Skills | ACP
Master foundational POCUS skills for your internal medicine practice with hands-on training, guidelines, and techniques. Register for upcoming sessions today.
POCUS Online Learning Activities
This training series consists of 13 online, self-paced activities based on common applications for POCUS in internal medicine and with an emphasis on image analysis.
In-Person Courses for Physicians
Elevate patient care through hands-on training and advanced ultrasound techniques with in-person POCUS courses for physicians. View dates and register today.
Acquiring POCUS Equipment: Considerations and Advice
Webinar on Acquiring POCUS Equipment: Considerations and Advice.
Our Statement in Support of Point-of-Care Ultrasound in Internal Medicine | ACP
The American College of Physicians is formally acknowledging the important role of point-of-care ultrasound (POCUS) in internal medicine. Read our statement here.
Displaying 751 - 760 of 6848 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.
Comparative Efficacy and Safety of Wakefulness-Promoting Agents for Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea: A Systematic Review and Network Meta-analysis: Annals of Internal Medicine: Vol 176, No 5
Background: Excessive daytime sleepiness (EDS) is common among patients with obstructive sleep apnea (OSA). The comparative effectiveness of pharmacologic agents is unknown. Purpose: To compare the effectiveness of drugs for EDS in OSA using network meta-analysis. Data Sources: MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov to 7 November 2022. Study Selection: Reviewers identified randomized trials that enrolled patients with EDS-associated OSA on or eligible for conventional therapy assigned to any pharmacologic intervention. Data Extraction: Paired reviewers independently extracted data addressing effects of drugs on the Epworth Sleepiness Scale (ESS), Maintenance of Wakefulness Test (MWT), and adverse events at the longest reported follow-up. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Data Synthesis: Fourteen trials (3085 patients) were eligible. At 4 weeks, compared with placebo, solriamfetol improves ESS scores (mean difference [MD], −3.85 [95% CI, −5.24 to −2.50]; high certainty), and armodafinil–modafinil (MD, −2.25 [CI, −2.85 to −1.64]; moderate certainty) and pitolisant–H3-autoreceptor blockers (MD, −2.78 [CI, −4.03 to −1.51]; moderate certainty) probably improve ESS scores. At 4 weeks, compared with placebo, solriamfetol (standardized mean difference [SMD], 0.9 [CI, 0.64 to 1.17]) and armodafinil–modafinil (SMD, 0.41 [CI, 0.27 to 0.55]) improve MWT (both high certainty), whereas pitolisant–H3-autoreceptor blockers probably do not (moderate certainty). At 4 weeks, armodafinil–modafinil probably increases the risk for discontinuation due to adverse events (relative risk [RR], 2.01 [CI, 1.14 to 3.51]; moderate certainty); solriamfetol may increase the risk for discontinuation due to adverse events (RR, 2.07 [CI, 0.67 to 6.25]; low certainty). Low certainty evidence suggests these interventions may not increase the risk for serious adverse events. Limitations: There is limited evidence on long term or effectiveness among patients nonadherent or with mixed adherence to conventional OSA therapies. Conclusion: Solriamfetol, armodafinil–modafinil, and pitolisant reduce daytime sleepiness for patients with OSA already on conventional therapy, with solriamfetol likely superior. Adverse events probably increase the risk for discontinuation of armodafinil–modafinil and may increase the risk for discontinuation with solriamfetol. Primary Funding Source: None.
Safety and Efficacy of Combination SARS-CoV-2 Neutralizing Monoclonal Antibodies Amubarvimab Plus Romlusevimab in Nonhospitalized Patients With COVID-19
Background: Development of safe and effective SARS-CoV-2 therapeutics is a high priority. Amubarvimab and romlusevimab are noncompeting anti–SARS-CoV-2 monoclonal antibodies with an extended half-life. Objective: To assess the safety and efficacy of amubarvimab plus romlusevimab. Design: Randomized, placebo-controlled, phase 2 and 3 platform trial. (ClinicalTrials.gov: NCT04518410) Setting: Nonhospitalized patients with COVID-19 in the United States, Brazil, South Africa, Mexico, Argentina, and the Philippines. Patients: Adults within 10 days onset of symptomatic SARS-CoV-2 infection who are at high risk for clinical progression. Intervention: Combination of monoclonal antibodies amubarvimab plus romlusevimab or placebo. Measurements: Nasopharyngeal and anterior nasal swabs for SARS-CoV-2, COVID-19 symptoms, safety, and progression to hospitalization or death. Results: Eight-hundred and seven participants who initiated the study intervention were included in the phase 3 analysis. Median age was 49 years (quartiles, 39 to 58); 51% were female, 18% were Black, and 50% were Hispanic or Latino. Median time from symptom onset at study entry was 6 days (quartiles, 4 to 7). Hospitalizations and/or death occurred in 9 (2.3%) participants in the amubarvimab plus romlusevimab group compared with 44 (10.7%) in the placebo group, with an estimated 79% reduction in events (P < 0.001). This reduction was similar between participants with 5 or less and more than 5 days of symptoms at study entry. Grade 3 or higher treatment-emergent adverse events through day 28 were seen less frequently among participants randomly assigned to amubarvimab plus romlusevimab (7.3%) than placebo (16.1%) (P < 0.001), with no severe infusion reactions or drug-related serious adverse events. Limitation: The study population was mostly unvaccinated against COVID-19 and enrolled before the spread of Omicron variants and subvariants. Conclusion: Amubarvimab plus romlusevimab was safe and significantly reduced the risk for hospitalization and/or death among nonhospitalized adults with mild to moderate SARS-CoV-2 infection at high risk for progression to severe disease. Primary Funding Source: National Institute of Allergy and Infectious Diseases of the National Institutes of Health.
How Would You Resuscitate This Patient With Septic Shock?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center: Annals of Internal Medicine: Vol 176, No 2
Sepsis is a potentially life-threatening systemic dysregulatory response to infection, and septic shock occurs when sepsis leads to systemic vasodilation and subsequent tissue hypoperfusion. The Surviving Sepsis Campaign published updated guidelines in 2021 on the management of sepsis and septic shock. Here, in the context of a patient with septic shock, 2 critical care specialists discuss and debate conditional guideline recommendations on using lactate to guide resuscitation, the use of balanced crystalloids versus normal saline, and the use of corticosteroids.