JAMA Internal Medicine
@JAMAInternalMed
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JAMA Internal Medicine is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications.
Joined July 2009
Urgency is not an emergency. Using IV #drugs for hypertensive urgency can lead to more harm than good @IcahnMountSinai #highvaluecare
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Study findings do not support the treatment of elevated inpatient blood pressures in hospitalized older adults without evidence of end organ damage and highlight the need for randomized clinical trials of inpatient blood pressure treatment targets.
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JAMA Internal Medicine introduces a new series, the Guide to Statistics and Methods, to be accessible to clinicians and researchers contextualizing and interpreting statistical methods applied in studies published in JAMA Internal Medicine.
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Findings suggest that older patients, particularly those with limited autonomy, who spend the night in the ED awaiting hospital admission may have a higher risk of in-hospital mortality and morbidity; they should be prioritized for admission to a ward.
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SGLT-2 inhibitors and GLP-1 receptor agonists are linked to a lower risk of #COPD exacerbations compared to DPP-4 inhibitors in patients with type 2 #diabetes and COPD. @avikray_md, @wbfeldman
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#Hypertension is common in the inpatient setting, but antihypertensive intensification is not. Intensification of therapy without signs of end-organ damage is associated with worse outcomes
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Most viewed in the last 7 days from @JAMAInternalMed: . Clinical Insights by @TimAndersonMD and @ZacharyGJacobs proposes a new framework for managing asymptomatic blood pressure elevation in the hospital setting.
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Metformin was associated with a lower rate of asthma attacks, with further reductions with the use of GLP-1RA.
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Defecation-induced cardiac arrest is an unrecognized cause of sudden cardiac death in patients with advanced cardiomyopathy. An increase in parasympathetic tone with sympathetic withdrawal is suggested. In contrast to atropine, epinephrine should be used
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In this randomized clinical trial, a 5-day course of oral ivermectin administered during the first week of #COVID19 illness did not reduce the risk of developing severe disease, when compared with standard of care alone.
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The generic names of many new drugs are unpronounceable. It is embarrassing and unsafe for patients. Let's fix this.
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Most viewed in the last 7 days from @JAMAInternalMed: . Vitamin K2 supplementation significantly reduced the frequency, intensity, and duration of nocturnal leg cramps in an older population with good safety.
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Topical NSAIDs are associated with greater pain relief without increase in adverse events when treating musculoskeletal conditions such as sprains, strains, and contusions.
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This study found that 46% of all meta-analysis publications of the ARISTOTLE clinical trial had conclusions altered by publications with falsified data, and 32% of all the analyses had a considerable change in the outcome.
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Elevated blood pressure in the hospital is common and most often asymptomatic. This Clinical Insight article by @TimAndersonMD and @ZacharyGJacobs proposes a new framework for managing asymptomatic blood pressure elevation in the hospital setting.
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An AI chatbot generated quality & empathetic responses to patient questions posed in an online forum, finds study. Chatbot-generated responses were preferred to physician responses. Further exploration of this tech is necessary. #artificialintelligence
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Findings of this meta-analysis suggest that colorectal cancer screening with sigmoidoscopy may extend life by approximately 3 months; lifetime gain for other screening tests appears to be unlikely or uncertain.
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The great @sarahkliff on the high costs of ED care and surprise medical billing and lessons learned from her @voxdotcom reporting on the practice.
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Overdiagnosis of penicillin allergies leads to adverse consequences in the pre-op setting
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Diabetic Foot Guidelines: Test patients w #diabetes for peripheral neuropathy using the Semmes-Weinstein test
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Older adults taking statins for primary prevention may not benefit according to re-analysis of SPRINT trial data.
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Study suggests that the Epic Sepsis Model poorly predicts #sepsis; its widespread adoption despite poor performance raises fundamental concerns about sepsis management on a national level
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Monoclonal gammopathy of unknown significance is common, often discovered incidentally and indolent. This Review summarizes evidence on the diagnosis and management of monoclonal gammopathy of unknown significance to guide clinical decision-making.
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Most viewed in the last 7 days from @JAMAInternalMed: . Can vitamin K2 significantly reduce the frequency, duration, and severity of nocturnal leg cramps in the older population? .
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Dr. @sharon_inouye will become the Editor in Chief of JAMA Internal Medicine. Dr. Inouye is an internationally recognized leader in geriatric medicine and aging research.
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In this randomized clinical trial of overweight adults who habitually sleep <6.5 hours per night, sleep extension reduced daily energy intake by ~270 kcal. Maintaining adequate sleep duration could be a viable intervention to prevent or reverse obesity.
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After 14 years, JAMA Internal Medicine Editor @RFRedberg stepping down June 2023. Editorial milestones include #impactfactor 44.46; 15M+ annual article downloads; #LessIsMore series discussing unnecessary medical tests; #research on important topics like health care reform.
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2017 Hypertension Guideline.Begin meds if .- Clinical CVD or.- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or.- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or .1st-line meds =.- Thiazides .- CCBs.- ACE inhibitors or ARBs.
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Over the course of AY2016-2017, some internal medicine residents in a single academic medical center ordered an astonishing 7-8 times more diagnostic tests than their peers. Read the details here #lessismore
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From @JAMA_current: Absolute iron deficiency affects approximately 2 billion people worldwide. This narrative review examines the screening, diagnosis, and treatment of adults w/ absolute iron deficiency w/o anemia and iron-deficiency anemia. #ACC25
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2017 Hypertension Guideline.Begin meds if .- Clinical CVD or.- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or.- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or .1st-line meds =.- Thiazides .- CCBs.- ACE inhibitors or ARBs.
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Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing
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The Role of P Values and Hypothesis Tests in Clinical Research
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Treat benign paroxysmal positional #vertigo with the Epley maneuver http://t.co/3sZIMb3Csq
#BPV #epley
http://t.co/4p9x4T8RB2.
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Too Good To Be True? Helmet non-invasive ventilation reduced intubation and mortality
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Diabetic Foot Guidelines: Test patients w #diabetes for peripheral neuropathy using the Semmes-Weinstein test
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Overdiagnosis of penicillin allergies leads to adverse consequences in the pre-op setting
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The AST and ALT are a little elevated - now what? When the test of time may be a more useful and less harmful diagnostic tool: a Teachable Moment on the step-wise evaluation of mildly elevated transaminases. @grammargandhi @NilooLatifi #highvaluecare.
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Elevated blood pressure in the hospital is common and most often asymptomatic. This Clinical Insight article by @TimAndersonMD and @ZacharyGJacobs proposes a new framework for managing asymptomatic blood pressure elevation in the hospital setting.
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This Clinical Insights discusses new diagnostic criteria, risk stratification, and emerging treatments of metabolic dysfunction–associated steatotic liver disease.
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Benefits of physical activity have a threshold; a dose-response relationship study. http://t.co/prUmZJQtor
http://t.co/Zlh4HoFT04.
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This cohort study found overestimation of arterial oxygen saturation levels by pulse oximetry occurred in Asian, Black, and Hispanic patients with #COVID19 and delayed care compared with White patients. @AshFawzyMD @GoldenSherita @AmandaBradke @BTGaribaldi.
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A form of intermittent fasting called early time-restricted feeding (eTRE) was more effective for losing weight, lowering diastolic blood pressure, and improving mood than eating over a ≥12-hour window.
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The generic names of many new drugs are unpronounceable. It is embarrassing and unsafe for patients. Let's fix this.
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Primary preventive BP lowering prevent death and cardiovascular disease only when SBP is above 140 mmHg
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Did You Know? New studies indicate that the gut #microbiome can influence the effectiveness of #cancer immunotherapy and manipulating gut bacteria might expand the population of patients who benefit from treatment #PD1Inhibitors.
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Diabetic Foot Guidelines: Test patients w #diabetes for peripheral neuropathy using the Semmes-Weinstein test
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ChatGPT wrote History of Present Illness summaries that were comparable to those written by senior internal medicine residents.
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Most clinicians rarely use statistical terms to explain treatments, and overestimate of harm & benefits
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Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing
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Recurrent UTI pose unique management challenges in older women. Rather than testing and treating liberally, clinicians should focus on acute, localizing urinary symptoms, use clinical tests judiciously, and consider the risks of antibiotic overtreatment.
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Bariatric surgery was associated with a reduced risk of breast cancer in women with obesity. The risk reduction was strongest in women with high insulin levels at baseline.
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Diabetic Foot Guidelines: Test patients w #diabetes for peripheral neuropathy using the Semmes-Weinstein test
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Who needs a nutritional #supplement? Almost no one. Yet millions of Americans spend $$$ on vitamins & supplements without any #evidence of benefit. Read our patient page on the subject for more information & help deciding if you can toss that multivitamin
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Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing
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Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing
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It doesn't have to be in PubMed to count as a citation -.Medical Cannabis Laws and Opioid Mortality
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Among patients with suspected sepsis and no clear indication for antianaerobic coverage, administration of piperacillin-tazobactam was associated with higher mortality and increased duration of organ dysfunction compared with cefepime.
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Many patients are on multiple medications. Over time, some medications that were once helpful may no longer be needed. Safely lowering or stopping unnecessary medications is called deprescribing. Find out more with this JAMA Patient Page.
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Delirium associated with accelerated cognitive decline that continued for 72 months following the index delirium episode; it's uncertain if delirium causes cognitive decline or if pts with preclinical brain disease are more likely to develop delirium.
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Given what we now know about disease processes, an understanding of nutrition is as key to medical practice as an understanding of pharmaceuticals
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Older adults taking statins for primary prevention may not benefit according to re-analysis of SPRINT trial data.
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Midline catheters used for outpatient parenteral antimicrobial therapy (OPAT) had a lower risk of major complications compared to PICCs, especially for treatments lasting 14 days or fewer.
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2017 Hypertension Guideline.Begin meds if .- Clinical CVD or.- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or.- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or .1st-line meds =.- Thiazides .- CCBs.- ACE inhibitors or ARBs.
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2017 Hypertension Guideline.Begin meds if .- Clinical CVD or.- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or.- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or .1st-line meds =.- Thiazides .- CCBs.- ACE inhibitors or ARBs.
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Most new drugs fail to show adequate efficacy, safety in late-stage clinical trials
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How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care
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When initiated earlier in the disease course, GLP-1 receptor agonists are associated with a reduced risk of progression to cirrhosis in patients with metabolic dysfunction-associated steatotic liver disease.
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Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing
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Clinicians should verify the validity & impact of machine learning methods just as they would any other diagnostic or prognostic tool in @JAMA_current.
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#Hydroxychloroquine taken daily by hospital-based health care providers over 8 weeks did not prevent #SARSCoV2 infection, in a double-blind randomized placebo-controlled trial performed at 2 University of Pennsylvania hospitals
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Clinical Review: Management of Asthma in Adults
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No benefit found when pravastatin used for primary prevention in adults w/ moderate hyperlipidemia & hypertension
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Older adults taking statins for primary prevention may not benefit according to re-analysis of SPRINT trial data.
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In this randomized clinical trial, a hospital ward-based improvement program did not result in a reduction in most hospital-associated complications in older adults, although there was a significant reduction in delirium.
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Older adults taking #statins for primary prevention may not benefit according to re-analysis of SPRINT trial data.
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Cancer Screening, Overdiagnosis, and Regulatory Capture
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Topical NSAIDs are associated with greater pain relief without increase in adverse events when treating musculoskeletal conditions such as sprains, strains, and contusions.
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#Hydroxychloroquine taken daily by hospital-based health care providers over 8 weeks did not prevent #SARSCoV2 infection, in a double-blind randomized placebo-controlled trial performed at 2 University of Pennsylvania hospitals
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Continuing ACE-I/ARB in patients with declining kidney function may provide cardiovascular and survival benefits without excessive harm of ESKD.
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Diabetic Foot Guidelines: Test patients w #diabetes for peripheral neuropathy using the Semmes-Weinstein test
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The @JAMANetwork welcomes @sharon_inouye, the new Editor in Chief of @JAMAInternalMed. Dr. Inouye comes to us from @harvardmed. We are thrilled to have her lead JAMA Internal Medicine starting July 1.
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Comparison of patients just either side of the +ve D-dimer cutoff - who differ markedly in their probability of CTPA scan but are otherwise similar - found no eGFR difference up to 6 mths later, suggesting IV contrast is not linked w/long-term renal injury
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Did You Know? New studies indicate that the gut #microbiome can influence the effectiveness of #cancer immunotherapy and manipulating gut bacteria might expand the population of patients who benefit from treatment #PD1Inhibitors.
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Only 1 of 159 medical students correctly performed all 11 elements in a BP check challenge with simulated patients
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This Clinical Insights discusses new diagnostic criteria, risk stratification, and emerging treatments of metabolic dysfunction–associated steatotic liver disease.
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Mediterranean diet w olive oil or #nuts associated w improved cognitive function http://t.co/ASFq1XYfcs
#rct
http://t.co/Xnp8hGReOa.
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Doctors who receive opioid-related #marketing from pharmaceutical companies prescribe more #opioids the next year, shows new research from @The_BMC and @DrScottHadland
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How to mitigate burnout in physicians? A meta-analysis of interventions builds the evidence.
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Diabetic Foot Guidelines: Test patients w #diabetes for peripheral neuropathy using the Semmes-Weinstein test
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2017 Hypertension Guideline.Begin meds if .- Clinical CVD or.- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or.- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or .1st-line meds =.- Thiazides .- CCBs.- ACE inhibitors or ARBs.
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