Search Results for ""
- ACP Online (7607)
- Annals of Internal Medicine (6853)
- IM Matters (3141)
- ACP Hospitalist (2393)
- Annals of Internal Medicine: Clinical Cases (500)
- ACP Store (226)
Displaying 941 - 950 of 7607 in ACP Online
Obesity Management 1: Lifestyle Modification
Assist patients with obesity in establishing lifestyle modification goals, monitoring diet, engaging in physical activity, and achieving desired weight loss. After completing this activity, learners will be able to:
Obesity
Obesity is a common condition and a major cause of morbidity and mortality. Fortunately, weight loss treatment can reduce obesity-related complications. This review summarizes the evidence-based strategies physicians can employ to identify, prevent, and treat obesity, including best practices to diagnose and counsel patients, to assess and address the burden of weight-related disease including weight stigma, to address secondary causes of weight gain, and to help patients set individualized and realistic weight loss goals and an effective treatment plan.
Noncardiac Surgery Following COVID-19: A Coast-to-Coast Update
The Annals Consult Guys discuss the appropriate timing of elective surgery in patients following COVID-19. Have recommendations changed since early in the pandemic?
Newer Pharmacologic Treatments for Type 2 Diabetes
On 22 May 2024, Annals of Internal Medicine and ACP hosted a virtual forum to shed some light on the rationale behind these differing approaches and to help physicians select the most appropriate therapy for individual patients. Video of the program is available at Annals.org and is well worth watching, as the panelists address many common, vexing clinical questions.
Mini But Mighty: Quick Wins for Positive Organizational Change
NOTE: MOC is not available for this activity. In this webinar, Well-being Champion Carrie Horwitch, MD, MPH, MACP, Associate Clinical Professor at Virginia Mason, discusses how one person can make a difference by identifying ways to improve thriving at work. Dr. Horwitch guides you though several attainable ways to drive positive change and secure leadership buy-in for your well-being efforts.
Metabolic Dysfunction–Associated Steatotic Liver Disease
Metabolic dysfunction–associated steatotic liver disease (MASLD) is the most common chronic liver disease in the United States. It is characterized by steatosis in the liver and is potentially reversible. Risk factors include obesity, type 2 mellitus, and other metabolic disorders. Metabolic dysfunction–associated steatohepatitis (MASH), a more severe form of MASLD, puts patients at risk for cirrhosis, liver decompensation, and liver cancer. Diet, exercise, and weight loss are the cornerstones of management.
Mental Health and Burnout, Part 2
We're closing out Mental Health Awareness Month with the 2nd part of our discussion of burnout. Join us as we learn from Dr. Anand Jagannath, a clinician-educator hospitalist who experienced burnout as an early career physician, and then learned strategies that individuals and institutions can implement to better recognize and combat burnout.
Mental Health and Burnout, Part 1
While there has been increased awareness of the concept of burnout in general, many Internal Medicine physicians may have gaps in their knowledge as to what burnout is and how they may be affected by it. Given that over 50% of physicians have experienced symptoms of burnout at some point during their careers (with rates significantly increasing during the COVID-19 pandemic), it is imperative that they understand the signs and the physical and mental consequences burnout can have. This includes increased rates of medical errors, depression, suicide, and leaving the medical field.
Mediterranean Diet in the Management of Irritable Bowel Syndrome
In this episode of Annals On Call, Dr. Centor discusses dietary interventions for patients with irritable bowel syndrome with Dr. Imran Aziz.First, listen to the podcast. After listening, ACP members can take the CME/MOC quiz for free.
Medication Abortion in 2024: What Internal Medicine Physicians Need to Know
Video captured from Internal Medicine Meeting 2024. Cynthia Chuang, MD, MSc, FACP, Alexandra Bachorik, MD, EdM, Adelaide McClintock, MD, and Mindy Sobota, MD, MS, Mphil, address prevalence of early abortion and current restrictions that impede equity in access in the United States. They’ll also advise on how internal medicine physicians can serve as a resource to their patients by diagnosing pregnancy, prescribing pills, referring to other trusted clinicians, and/or sharing reliable Internet resources for tele-abortion care.
Displaying 941 - 950 of 6853 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.
A Framework for the Development of Living Practice Guidelines in Health Care
Background: Living practice guidelines are increasingly being used to ensure that recommendations are responsive to rapidly emerging evidence. Objective: To develop a framework that characterizes the processes of development of living practice guidelines in health care. Design: First, 3 background reviews were conducted: a scoping review of methods papers, a review of handbooks of guideline-producing organizations, and an analytic review of selected living practice guidelines. Second, the core team drafted the first version of the framework. Finally, the core team refined the framework through an online survey and online discussions with a multidisciplinary international group of stakeholders. Setting: International. Participants: Multidisciplinary group of 51 persons who have experience with guidelines. Measurements: Not applicable. Results: A major principle of the framework is that the unit of update in a living guideline is the individual recommendation. In addition to providing definitions, the framework addresses several processes. The planning process should address the organization's adoption of the living methodology as well as each specific guideline project. The production process consists of initiation, maintenance, and retirement phases. The reporting should cover the evidence surveillance time stamp, the outcome of reassessment of the body of evidence (when applicable), and the outcome of revisiting a recommendation (when applicable). The dissemination process may necessitate the use of different venues, including one for formal publication. Limitation: This study does not provide detailed or practical guidance for how the described concepts would be best implemented. Conclusion: The framework will help guideline developers in planning, producing, reporting, and disseminating living guideline projects. It will also help research methodologists study the processes of living guidelines. Primary Funding Source: None.
Comparative Effectiveness and Safety Between Apixaban, Dabigatran, Edoxaban, and Rivaroxaban Among Patients With Atrial Fibrillation: A Multinational Population-Based Cohort Study: Annals of Internal Medicine: Vol 175, No 11
Background: Current guidelines recommend using direct oral anticoagulants (DOACs) over warfarin in patients with atrial fibrillation (AF), but head-to-head trial data do not exist to guide the choice of DOAC. Objective: To do a large-scale comparison between all DOACs (apixaban, dabigatran, edoxaban, and rivaroxaban) in routine clinical practice. Design: Multinational population-based cohort study. Setting: Five standardized electronic health care databases, which covered 221 million people in France, Germany, the United Kingdom, and the United States. Participants: Patients who were newly diagnosed with AF from 2010 through 2019 and received a new DOAC prescription. Measurements: Database-specific hazard ratios (HRs) of ischemic stroke or systemic embolism, intracranial hemorrhage (ICH), gastrointestinal bleeding (GIB), and all-cause mortality between DOACs were estimated using a Cox regression model stratified by propensity score and pooled using a random-effects model. Results: A total of 527 226 new DOAC users met the inclusion criteria (apixaban, n = 281 320; dabigatran, n = 61 008; edoxaban, n = 12 722; and rivaroxaban, n = 172 176). Apixaban use was associated with lower risk for GIB than use of dabigatran (HR, 0.81 [95% CI, 0.70 to 0.94]), edoxaban (HR, 0.77 [CI, 0.66 to 0.91]), or rivaroxaban (HR, 0.72 [CI, 0.66 to 0.79]). No substantial differences were observed for other outcomes or DOAC–DOAC comparisons. The results were consistent for patients aged 80 years or older. Consistent associations between lower GIB risk and apixaban versus rivaroxaban were observed among patients receiving the standard dose (HR, 0.72 [CI, 0.64 to 0.82]), those receiving a reduced dose (HR, 0.68 [CI, 0.61 to 0.77]), and those with chronic kidney disease (HR, 0.68 [CI, 0.59 to 0.77]). Limitation: Residual confounding is possible. Conclusion: Among patients with AF, apixaban use was associated with lower risk for GIB and similar rates of ischemic stroke or systemic embolism, ICH, and all-cause mortality compared with dabigatran, edoxaban, and rivaroxaban. This finding was consistent for patients aged 80 years or older and those with chronic kidney disease, who are often underrepresented in clinical trials. Primary Funding Source: None.
Associations of Atrial Fibrillation After Noncardiac Surgery With Stroke, Subsequent Arrhythmia, and Death: A Cohort Study: Annals of Internal Medicine: Vol 175, No 8
Background: Postoperative atrial fibrillation (AF) after noncardiac surgery confers increased risks for ischemic stroke and transient ischemic attack (TIA). How outcomes for postoperative AF after noncardiac surgery compare with those for AF occurring outside of the operative setting is unknown. Objective: To compare the risks for ischemic stroke or TIA and other outcomes in patients with postoperative AF versus those with incident AF not associated with surgery. Design: Cohort study. Setting: Olmsted County, Minnesota. Participants: Patients with incident AF between 2000 and 2013. Measurements: Patients were categorized as having AF occurring within 30 days of a noncardiac surgery (postoperative AF) or having AF unrelated to surgery (nonoperative AF). Results: Of 4231 patients with incident AF, 550 (13%) had postoperative AF as their first-ever documented AF presentation. Over a mean follow-up of 6.3 years, 486 patients had an ischemic stroke or TIA and 2462 had subsequent AF; a total of 2565 deaths occurred. The risk for stroke or TIA was similar between those with postoperative AF and nonoperative AF (absolute risk difference [ARD] at 5 years, 0.1% [95% CI, −2.9% to 3.1%]; hazard ratio [HR], 1.01 [CI, 0.77 to 1.32]). A lower risk for subsequent AF was seen for patients with postoperative AF (ARD at 5 years, −13.4% [CI, −17.8% to −9.0%]; HR, 0.68 [CI, 0.60 to 0.77]). Finally, no difference was seen for cardiovascular death or all-cause death between patients with postoperative AF and nonoperative AF. Limitation: The population consisted predominantly of White patients; caution should be used when extrapolating the results to more racially diverse populations. Conclusion: Postoperative AF after noncardiac surgery is associated with similar risk for thromboembolism compared with nonoperative AF. Our findings have potentially important implications for the early postsurgical and subsequent management of postoperative AF. Primary Funding Source: National Institute on Aging.