Internal Medicine - Science topic

BACKGROUND Non-ST segment elevation myocardial infarction (NSTEMI) poses significant challenges in clinical management due to its diverse outcomes. Understanding the prognostic role of hematological parameters and derived ratios in NSTEMI patients could aid in risk stratification and improve patient care. AIM To evaluate the predictive value of hem...

Background: Medication errors, especially in dosage calculation, pose risks in healthcare. Artificial intelligence (AI) systems like ChatGPT and Google Bard may help reduce errors, but their accuracy in providing medication information remains to be evaluated. Aim: To evaluate the accuracy of AI systems (ChatGPT 3.5, ChatGPT 4, Google Bard) in prov...

Lung ultrasound (LUS) is an imaging modality of growing importance in human medicine. LUS has been extensively applied to human patients. Guidelines have been created for internal medicine, describing ultrasonographic features of various lung pathologic processes. Such guidelines do not exist for veterinary medicine, and studies on the utility of L...

Objective Physicians play a key role in vaccination advocacy. To explore potential educational gaps, we surveyed the knowledge and opinions on vaccination, as well as their own vaccination status, among Chinese medical students and residents in a single medical institute. Methods We recruited sixth- and seventh-year medical students and internal m...

Despite being increasingly adopted in various regions, the model of Hospital‐at‐home can still appear to be confusing to many healthcare workers. The authors examined and summarized the existing concepts and implementations of Hospital‐at‐home. How Hospital‐at‐home contrasts to traditional inpatient models were outlined.

Objectives Time pressure and time constraints have been shown to affect diagnostic accuracy, but how they interact is not clear. The current study aims to investigate the effects of both perceived time pressure (sufficient vs. insufficient time) and actual time constraints (lenient vs. restricted time limit) with regard to diagnostic accuracy. Met...

Aim The present study aimed to investigate the relationship between delirium and tryptophan and its metabolites in critically ill older patients. Methods This prospective and observational study was conducted on patients who were > 60 years of age and hospitalized for at least 24 h at the internal medicine ICU in the tertiary health care unit ( n...

Background/Objectives: The management of inflammatory bowel disease (IBD) includes, besides the control of symptoms, the prevention of organ damage and the improvement of the overall disability. Methods: A single-centered, cross-sectional, non-interventional and population-based study was conducted between October 2023 and August 2024 in the Depart...

New residents are often unprepared to respond to medical emergencies. To address this gap, we implemented a simulated cross-cover paging curriculum. All senior medical students enrolled in a required specialty-specific (internal medicine, procedures, emergency medicine [EM], obstetrics and gynecology [OBGYN], family medicine and pediatrics) residen...

Objectives People living with HIV/AIDS today expect a typical lifespan, although many continue to encounter psychological and societal challenges, including stigma and discrimination. In healthcare settings, this may manifest as refusal of care or treatment, non‐consensual testing, confidentiality breaches, and unfavourable attitudes, among other i...

Background: Behavioral alerts (BAs) are electronic health record communication tools used to notify clinicians and staff about patient behavioral incidents. Despite their widespread presence, limited research exists on the content and use of BAs. Methods: This study took place in a large, urban, academic general internal medicine practice. Demograp...

Statins have been used in clinical practice for more than 40 years to treat and prevent atherosclerosis and its complications. The results of observational studies indicate that, despite a large evidence base, statins in Russia are still prescribed in low doses, for a maximum of 6 months, leading to a low percentage of achieving the target levels o...

Introduction: Obstruction of the pulmonary artery and its branches increases the pulmonary vascu- lar resistance, resulting in pulmonary hypertension and right ventricular (RV) dysfunction.1,2 Aim: To analyze the correlation between the pulmonary artery obstruction index (PAOI) score obtained from quantifying obstruction in pulmonary embolism (PE),...

Introduction: Patients with Autoimmune Inflammatory Rheumatic Disease (AIIRD) are at an increased risk of developing infectious diseases. Vaccination is recommended for these patients by various societies as a preventive strategy. Despite this, the coverage of vaccination is exceedingly low, especially in developing countries. Aim: To estimate th...

Background Internal medicine (IM) residents face significant challenges when pursing subspecialty fellowships. This study determined the factors that differentiate IM residents entering pulmonary and critical care medicine (PCCM) fellowships from those pursuing other careers. Methods We completed a retrospective study of 12 classes of IM residents...

Objective Hospitals in India use the National Accreditation Board for Hospitals and Healthcare Providers guidelines as criteria to ensure safe prescribing practices. This audit was conducted to provide insight into in-patient prescription of drugs to (1) evaluate the quality of prescriptions (2) reduce prescription and medication errors (3) improve...

Background: More than two-thirds of patients with functional gastrointestinal disorders (FGIDs) experience various degrees of mental health issues. Although studies indicate that FGIDs are related to depressive symptoms, sleep disorders, and somatic symptoms, the underlying mechanism between these variables remains unknown. Our objective was to est...

Interprofessional teamwork is important for the provision of safe, high value patient care and is recognized as essential by the ACGME. We aimed to assess the impact of an interprofessional continuity clinic teamwork curriculum on perceptions of team development and patient safety. This project was conducted in an IM Resident Continuity Clinic wher...

Background and objectives The aim of the present study was to assess the effect of sociodemographic factors on knowledge, attitudes, motivation and potential barriers of university students towards blood donation in the order to more effective donation promotion. Design The cross-sectional study was conducted on 1000 participants (500 non-blood do...

Purpose Artificial intelligence (AI) holds great potential for revolutionizing health care by providing clinicians with data-driven insights that support more accurate and efficient clinical decisions. However, applying AI in clinical settings is often challenging due to the complexity and vastness of medical information. This perspective article e...

Objectives This study aims to investigate the satisfaction levels of inpatients and identify the determinants of inpatient satisfaction and hospital recommendations. Design A cross-sectional study was conducted in 2022. Setting A tertiary general hospital in Sichuan Province, China. Participants 271 inpatients were randomly selected and studied....

Introducción: El uso de la ultrasonografía en el punto de atención (PoCUS) ha ganado relevancia en la práctica médica, mejorando la capacidad diagnóstica y la seguridad de los pacientes. Sin embargo, en Uruguay, la formación en PoCUS para médicos internistas es limitada. El objetivo es lograr la implementación de la formación de PoCUS en los posgra...

Abstract Abstract Background: SARS can cause multiple organ injury where the major organ affected is the lung. It has a deleterious effect on the thyroid gland. The viral infection and the thyroid gland-have a complex interplay through immunomodulatory signal-ing molecules and hormones. Aim of Study: Was to evaluate the prevalence of thyroid dysfun...

Melanoma represents a formidable challenge in dermatological oncology due to its resistance to conventional treatments. The Celandine Alkali Injection Formula (CAIF) offers benefits on clinical internal medicine treatments, within which chelidonine and tetrandrine are recognized as potential quality markers. However, their synergistic mechanisms fa...

A cinomose canina é uma enfermidade de alta contagiosidade provocada por um vírus pertencente à família Paramyxoviridae, do gênero Morbillivirus. Acomete uma ampla variedade de hospedeiros além de cães domésticos. Esse vírus tem grande incidência em animais jovens, e caracteriza-se por uma elevada taxa de mortalidade. São acometidos os cães não vac...

Dear Readers, We are thrilled to bring you the second issue of the ninth volume of POCUS Journal. Published since 2016, POCUS Journal is the only multi-disciplinary, peer-reviewed, POCUS-focused journal that is free for authors and readers alike. This issue features a variety of POCUS articles from around the world: from North America, South Americ...

Background: The availability of faculty proficient in point of care ultrasound (POCUS) has emerged as a barrier to the ongoing expansion of POCUS across the field of internal medicine. We sought to examine the faculty graduates of our institutional POCUS program to identify characteristics associated with long-term proficiency to inform curricula a...

Point of care ultrasound (POCUS) is a complex psychomotor skill that requires scaffolded support for skill acquisition. However, the effect of spaced curricular elements on learner POCUS behaviors are not clearly understood. Using a multi-site observational cross-sectional survey study, we measured resident baseline POCUS use, behaviors, and attitu...

Background/Objectives: Type 2 diabetes mellitus (DM2) and hypothyroidism are two of the most common endocrine disorders in clinical practice. Hospital length of stay (LOS) is a quality metric of the health systems. We evaluated the association between elevated thyroid-stimulating hormone (TSH) levels and prolonged LOS among all adult patients (age...

OBJECTIVES One of the major contributing factors to the opioid crisis, marked by a surge in opioid prescriptions, includes inadequate adherence to guideline-based pain management practices, highlighting the need for a comprehensive curriculum during residency training. In this study, we aim to assess opioid exposure prevalence among hospitalized pa...

Objective To assess the effect of goal-directed mobilisation (GDM) on physical functioning in medical inpatients. Design Randomised, controlled, single-centre, parallel, superiority trial with a 3-month follow-up and blinded outcome assessment. Setting General internal medicine wards of a Swiss tertiary acute hospital, September 2021 to April 202...

A dataset of 2261 cases yielded a cleaned sample of 2083, with 1217 complete cases. • Mean T-scores for physical health (PHS) and mental health (MHS) differed significantly (p<0.001) between admission and discharge across all rehabilitation domains (Figure 1). The pre-post effect for MHS in paraplegic rehabilitation was significant at p=0.002. • Th...

Background Traditional assessments in postgraduate medical training tend to emphasize cognitive skills while often neglecting the psychomotor and affective domains. The mini-clinical evaluation exercise (mini-CEX) addresses these limitations by evaluating clinical, communication, and humanistic skills with immediate feedback. This study aimed to ev...

The aim of this brief report is to evaluate sodium-glucose cotransporter 2 inhibitors (SGLT2-I) effects on patients with both refractory ascites and type 2 diabetes mellitus (T2D). We consecutively recruited all the diabetic patients with refractory ascites due to decompensated liver cirrhosis admitted between February and May 2023 at the Internal...

Introduction In patients with chronic obstructive pulmonary disease (COPD), oxygen delivery to the heart may be impaired during altitude travel. We assessed ECG-derived signs of cardiac ischemia, and effects of preventive acetazolamide therapy in COPD patients travelling to high altitude. Methods Patients with COPD, GOLD grade 2-3, mean±SD, FEV 1...

Generative artificial intelligence (generative AI) is a new technology with potentially broad applications across important domains of healthcare, but serious questions remain about how to balance the promise of generative AI against unintended consequences from adoption of these tools. In this position statement, we provide recommendations on beha...

Background: Proton pump inhibitors (PPIs) are commonly prescribed to hospitalized patients, but many of these prescriptions may not be based on evidence-based indications. It’s important to understand that inappropriate prescribing of PPIs can lead to unnecessary medications and financial burdens. Unfortunately, there are not many recent studies ex...

Background: Acute kidney injury (AKI) is a frequent complication associated with severe COVID-19 and has been linked to increased mortality. While vaccination against SARS-CoV-2 has shown effectiveness in reducing severe COVID-19 outcomes, its impact on the development of AKI among hospitalized patients remains unclear. Objective: To evaluate the e...

Objective To examine practices of providers and nursing staff in evaluating febrile patients and identify drivers of excessive diagnostic testing. Design Prospective multiple-choice surveys. Setting Inpatient areas and the Emergency Department at Rhode Island Hospital (RIH) in Providence, RI. Participants & Methods We conducted two surveys focus...

In 2018, the WHO published a methodology for conducting a point prevalence survey (PPS) of antibiotic use in hospitals. The aim of this study is to report the use of antibiotics in six second-level hospitals in Mexico using this methodology. Methods: A multicenter cross-sectional study based on the 2021–2023 adaptation for Latin American hospitals...

Bleeding complications associated with oral anticoagulant (OAC) frequently lead to emergency department visits and hospitalization. Short-term all-cause mortality after severe bleeding is substantial ranging from about 10% for gastrointestinal bleeding (the most frequent single site) to about 50% for intracranial bleeding. A protocolized, multidisc...

El cuidado humanizado es un imperativo moral de la práctica en enfermería. El objetivo general de esta investigación fue analizar las características del cuidado humanizado que proveen los profesionales de enfermería en tres servicios de un hospital ecuatoriano: medicina interna, cirugía general, así como de ginecología y obstetricia. La investigac...

Resumen Objetivos Describir la variante de hemoglobina que interfiere en el análisis de HbA 1c mediante HPLC de intercambio catiónico. Caso clínico Paciente de 78 años que acude a consulta de Medicina Interna para una revisión rutinaria, donde se incluye la determinación de HbA 1c para la detección de diabetes. El paciente presenta como anteceden...

Introduction: Palliative care (PC) is an approach that improves the quality of life of patients facing problems associated with life-threatening illnesses.Objective: To investigate the prevalence, clinical, and epidemiological profile of hospitalized patients and those referred for PC in a tertiary hospital ward in a capital city in the Northeast o...

Gastric pH is a key factor in the development of equine squamous gastric disease (ESGD). Although acid injury is unlikely the primary cause of equine glandular gastric disease (EGGD), low pH may promote mucosal damage. Gastric pH is influenced by roughage uptake, as chewing increases the alkaline saliva production. The proton pump inhibitor omepraz...

Introduction/Objectives Insomnia is a common sleep disorders that affects most individuals in the United States, and worldwide. Insomnia is linked with an increased risk of atrial fibrillation (AF) in adults, although the strengths of association were weak, especially in the elderly population. AF is estimated to affect approximately 3 to 6 million...

Psoriasis is an immune-mediated inflammatory disease that affects the skin and joints and is chronic, non-communicable, painful, disfiguring and disabling. The prevalence of psoriasis in countries ranges from 0.09% to 11.4%. The reported prevalence in India is 0.44 - 2.8%. Even though psoriasis was found long ago, its etiology and treatment are not...

Echocardiography has emerged as an invaluable tool in internal medicine, providing real-time, non-invasive evaluation of cardiac structure and function. Its clinical utility spans a wide range of applications, including the diagnosis and management of heart failure, valvular heart diseases, and cardiomyopathies, as well as systemic conditions like...

Objectives: This study aimed to investigate factors associated with nurses' self-efficacy in oral care among infection-sensitive patients in a university hospital. Material and methods: All the nurses working in five wards of internal medicine and one department of oncology at Oulu University Hospital, Finland (n = 114) were recruited. Data were...

Background Therapeutic digital health applications (DiGAs) are expected to significantly enhance access to evidence-based care. Since 2020, German physicians and psychotherapists have been able to prescribe approved DiGAs, which are reimbursed by statutory health insurance. This study investigates the usage, knowledge and perception of DiGAs as wel...

BACKGROUND High-dose steroid administration is a common initial therapeutic approach for Vogt–Koyanagi–Harada disease (VKH). Nonetheless, administering substantial doses of steroids to pregnant women necessitates meticulous consideration due to the potential impacts on the mother and fetus. We present a case wherein steroid pulse therapy was admini...

Aim Acute kidney injury (AKI) presents a high mortality complication in patients with acute myocardial infarction (AMI). Yet, its correlation with non-ST elevation myocardial infarction (NSTEMI) remains neglected in the literature. This study aims to investigate the prevalence, risk factors, clinical features, and short-term outcomes associated wit...

Background Proper diagnosis in primary care is crucial due to the large number of skin cancer diagnoses each year and its associated growing economic burden. Understanding how primary care providers can be best trained in dermoscopy is instrumental in helping primary care providers differentiate benign and malignant cutaneous lesions so that approp...

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnosti...

Background Checkpoint inhibitor-induced colitis (CPI-c) is the second most common toxicity from immune checkpoint blockade, conferring significant morbidity and a high burden of immunosuppressive therapy.¹ The impact of endoscopically evident inflammation (macroscopic inflammation, MacI) compared to histological changes only (microscopic inflammati...

Background Decades of medical data show worse patient outcomes among racial and gender minorities due to implicit, explicit, and structural biases. Increasing representation of marginalized groups among care providers is imperative to help address this. Limited literature exists on bias awareness strategies for interviewers during the selection of...

The increasing use of digital applications in healthcare has led to a greater need for patient education materials. These materials, often in the form of pamphlets, booklets, and handouts, are designed to supplement physician–patient communication and aim to improve patient outcomes. However, the effectiveness of these materials can be hindered by...

Background :To determine the prevalence of 25-hydroxy vitamin D (25(OH)D) deficiency in healthy adult patients who presented to our hospital in Istanbul province and to present the difference between vitamin 25(OH)D levels by gender, age group, season, and month. Materials and Methods: The vitamin 25(OH)D levels of 9,778 adults who presented to the...

Background The differences in clinical bioethics between the Mediterranean and Latin American cultures have not been analyzed. The objective of the study is to compare the ethical conflicts that internists in Spain, Mexico and Argentina have. Methods Cross-sectional observational study through a survey directed at internists from Spain, Argentina...

Background Limitation declarations are commonly deemed essential to uphold intellectual humility for scientific research, but little has been reported about the limitation statements in published original research articles. This meta-research study aims to investigate the trends of limitation statements among three leading general medical journals...

AIMS OF THE STUDY: Physicians frequently prescribe antipsychotics off-label to treat, among others, insomnia and anxiety. The Swiss “smarter medicine – Choosing Wisely” campaign has tried to raise awareness about the risks and to limit benzodiazepine and Z-drug prescriptions. In the Italian-speaking part of Switzerland, our network of public hospit...

A 23-year-old nonsmoking, female was sent to respiratory medicine department with suspicion of malignant intrathoracic lesion. The diagnosis was confirmed by performing Computed tomography of thorax. Suspicion for Benign posterior mediastinal schwannoma was raised as it is one of the most common posterior mediastinal mass. Complete resection of the...

Abstract Background Mortality among patients with liver cirrhosis has recently increased in Indonesia. However, predicting the prognosis of patients hospitalized with liver cirrhosis remains a clinical challenge due to its variability and dependence on multiple factors. A simple and accurate method is required to identify high-risk patients. This s...

What do we mean when we diagnose a patient with a disease? What does it mean to say that two people have the same disease? In this paper, I argue that diseases are natural kinds, using a conception of kinds derived from John Stuart Mill and Ruth Millikan. I demonstrate that each disease is a natural kind and that the shared properties occur as a re...

Próximamente, se cumplirá una década del fallecimiento del doctor en ciencias José Rogelio Menéndez López, lo que constituye un momento oportuno para evocar su ejemplar trayectoria profesional como médico militar en los servicios médicos de las Fuerzas Armadas Revolucionarias. Por este motivo, profundizar en el conocimiento de su vida y obra, ampli...

Objective Virtual patient cases are a scalable and engaging tool for training medical professionals. Strategies and frameworks for their implementation in teaching and training settings are few, technically complicated and/or expensive. We developed and evaluated open source and free virtual patient cases to test knowledge acquisition during an ech...

Background: Malnutrition among older adults is associated with numerous adverse effects, including increased morbidity, mortality, prolonged hospital stays, and a heightened risk of falls. This study aims to investigate the prevalence of malnutrition in different groups of older adults using the F-MNA, anthropometry, and s-albumin and the associati...

Liver cirrhosis and its complications constitute one of the most important causes of hospitalization in internal medicine departments. Liver cirrhosis is not a homogeneous disease entity, but is the final stage of many different liver diseases, and the most important causes leading to the development of liver cirrhosis are alcoholic liver disease a...

Background and aim In 2019, a three-year internal medicine training (IMT) program replaced the two-year core medical training program in the United Kingdom, incorporating the first year of medical registrar (MR) training into the same curriculum. In light of the considerable evidence supporting the effectiveness of simulation-based education (SBE)...

Objective: To observe the clinical efficacy and safety of Wenzhong Hewei Formula in treating spleen and stomach qi deficiency syndrome in internal medicine diseases. Methods: Sixty patients with spleen and stomach qi deficiency syndrome admitted to the hospital from April 2022 to June 2023 were randomly divided into observation and control groups,...

Objectives: To test the performance of the Glasgow Admission Prediction Score (GAPS) and Ambulatory Score (Amb score), and derive and validate a novel score for the identification of Emergency Department (ED) attendances suitable for treatment by Same Day Emergency Care (SDEC) services. Design: Retrospective diagnostic study using routinely collect...

Background: Point of Care Ultrasound (POCUS) is a vital tool in rheumatology for detecting pathologies like osteophytes and joint effusion. Its integration into rheumatology electives during internal medicine clerkship and residency is limited, despite its emphasis in pre-clinical years. Methods: In this QIRB-approved, single-center, prospective st...