Discoveries & Impact December
Discoveries & Impact highlights select scientific discoveries and editorial commentaries for each section in the Department of Internal Medicine
To see the complete list of publications from the Department of Internal Medicine, please refer to the report under Related Documents.
Cardiovascular Medicine
In the Journal of the American Heart Association, researchers demonstrate that in heart transplantation, higher body mass index (BM) was associated with lower odds of transplantation and increased mortality. The authors used United Network for Organ Sharing data from 2006 to 2020 to analyze the effects of the new Organ Procurement and Transplantation Network allocation system on patients with obesity or severe obesity listed for cardiac transplantation. The findings point to an inverse relationship between BMI and likelihood of heart transplantation.
Chouairi F, Milner A, Sen S, Guha A, Stewart J, Jastreboff AM, Mori M, Clark KA, Miller PE, Fuery MA, Rogers JG, Notarianni A, Jacoby D, Maulion C, Anwer M, Geirsson A, Desai NR, Ahmad T, Mullan CW. Impact of Obesity on Heart Transplantation Outcomes. J Am Heart Assoc. 2021 Dec 7;10(23):e021346. doi: 10.1161/JAHA.121.021346. Epub 2021 Dec 2. PMID: 34854316.
Digestive Diseases
Michelle Hughes, MD, explains why she likes being a “GI Hospitalist,” – a gastroenterologist focused on in-hospital care of GI disorders. “When I tell people what I do, the response is usually the same: ‘you’re a what?’ Two years into practice, I now have a well-practiced elevator pitch ready to answer such questions,” Hughes writes in Digestive Diseases and Sciences. Read more: https://pubmed.ncbi.nlm.nih.gov/34478026/
Hughes ML. Why I Like Being in with the Inpatient Crowd: How I Took the Non-traditional Path of the GI Hospitalist. Digestive Diseases And Sciences 2021, 66(11):3674-3675. doi: 10.1007/s10620-021-07242-5. PMID: 34478026.
Geriatrics
With funding by the National Institute of Nursing Research and the National Institute of Aging, Terri Fried, MD, and her colleagues evaluated the efficacy of the Sharing and Talking About My Preferences (STAMP) intervention to encourage more adults to complete ACP. Fried and her colleagues published their findings in the Annals of Internal Medicine. Read more: https://pubmed.ncbi.nlm.nih.gov/34461035/
Fried TR, Paiva AL, Redding CA, Iannone L, O'Leary JR, Zenoni M, Risi MM, Mejnartowicz S, Rossi JS. Effect of the STAMP (Sharing and Talking About My Preferences) Intervention on Completing Multiple Advance Care Planning Activities in Ambulatory Care : A Cluster Randomized Controlled Trial. Annals Of Internal Medicine 2021, 174(11):1519-1527. doi: 10.7326/M21-1007. PMID: 34461035.
Endocrinology & Metabolism
Experts at the Yale Bone Center have published an update on screening guidelines and management of osteoporosis in Medical Clinics of North America. The guidelines focus primarily on postmenopausal women and emphasize a thorough assessment of any secondary causes of osteoporosis and mineral metabolism, as well as optimizing lifestyle measures and pharmacologic therapies. Learn more here.
Anam AK, Insogna K. Update on Osteoporosis Screening and Management. The Medical Clinics of North America 2021, 105(6):1117-1134. doi:10.1016/j.mcna.2021.05.016. PMID: 34688418.
General Internal Medicine and Pulmonary, Critical Care & Sleep Medicine
Polypharmacy—the taking of five different medications concurrently—is a well-known cause of frailty in the general population, but little is known about persons living with HIV (PLWH) who are on antiretroviral therapy as well as other medications. Using data from the Veterans Aging Cohort Study, Yale researchers conducted a cross-sectional analysis of 1,762 PLWH receiving ARV and 2,679 uninfected individuals. The rate of frailty in PLWH who took multiple medications was higher than those in the uninfected group. This may be useful information for physicians when they prescribe medications to patients with HIV. Learn more here.
Sung M, Gordon K, Edelman EJ, Akgün KM, Oursler KK, Justice AC. Polypharmacy and frailty among persons with HIV. AIDS Care 2021, 33(11):1492-1499. doi: 10.1080/09540121.2020.1813872. PMID: 32880183. PMCID: PMC7925692.
Hematology and Medical Oncology
Drug therapies such as proteasome inhibitors, immunomodulatory agents, and CD38-targeted monoclonal antibodies have improved longevity in patients with relapsed and/or resistant multiple myeloma (MM). Most patients with MM, however, eventually become resistant to these therapies. A report in Leukemia & Lymphoma sought to evaluate the cost-effectiveness of a novel therapy, selinexor, compared to available treatments and concluded that the current cost of this new drug is prohibitive. Learn more here.
Patel KK, Parker T, Di M, Bar N, Huntington SF, Giri S. Cost-effectiveness of once-weekly selinexor, bortezomib, and dexamethasone in relapsed or refractory multiple myeloma. Leukemia & Lymphoma 2021, 62(11):2777-2784. doi: 10.1080/10428194.2021.1933477. PMID: 34151696
Infectious Diseases
The Lancet Commission on Vaccine Refusal, Acceptance and Demand in the U.S.A., which is co-chaired by the director of the Yale Institute for Global Health, has published a report in The Lancet on the current state of COVID-19 vaccine refusal and acceptance. The report evaluated potential interventions, including mandates, vaccination reminder systems, and curbing the spread of vaccine misinformation. Learn more here.
Omer SB, Benjamin RM, Brewer NT, Buttenheim AM, Callaghan T, Caplan A, Carpiano RM, Clinton C, DiResta R, Elharake JA, Flowers LC, Galvani AP, Lakshmanan R, Maldonado YA, McFadden SM, Mello MM, Opel DJ, Reiss DR, Salmon DA, Schwartz JL, Sharfstein JM, Hotez PJ. Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA. Lancet. 2021 Nov 15:S0140-6736(21)02507-1. doi: 10.1016/S0140-6736(21)02507-1. Epub ahead of print. PMID: 34793741; PMCID: PMC8592561.
Nephrology
Researchers report on initial data following implementation of the 2017 Organ Procurement and Transplantation Network (OPTN) simultaneous liver-kidney transplantation policy, citing both accomplishments to date and remaining gaps related to policy success, organ allocation, and transplant patient outcomes. Read the article in American Journal of Transplantation.
Wilk AR, Booker SE, Stewart DE, Wiseman A, Gauntt K, Mulligan D, Formica RN. Developing simultaneous liver-kidney transplant medical eligibility criteria while providing a safety net: A 2-year review of the OPTN's allocation policy. American Journal Of Transplantation : Official Journal Of The American Society Of Transplantation And The American Society Of Transplant Surgeons 2021, 21(11):3593-3607. doi: 10.1111/ajt.16761. PMID: 34254434.
Rheumatology, Allergy & Immunology
Gout is the most common form of inflammatory arthritis in the world, yet its management remains suboptimal. Physicians and patients alike often have misconceptions about the role of diet in the treatment of gout. Yale researchers reviewed the evidence around the impact of individual foods as well as specific diets, including the DASH and Mediterranean diets on hyperuricemia, incident gout and flares. They concluded that the specific diets and individual foods appear to have a limited role in definitive management and urate-lowering therapy remains the mainstay of gout treatment. Learn more here.
A. Danve, S.T. Sehra and T. Neogi, Role of diet in hyperuricemia and gout, Best Practice & Research Clinical Rheumatology. doi:10.1016/j.berh.2021.