Latest news with #UniversityofMichiganMedicalSchool
UPI
a day ago
- Health
- UPI
Study: Urgent care often prescribes inappropriate medications
Urgent care clinics are handing out fistfuls of antibiotics, steroids and opioids for conditions these drugs won't help, a new study says. Photo by Adobe Stock/HealthDay News Urgent care clinics are handing out fistfuls of antibiotics, steroids and opioids for conditions these drugs won't help, a new study says. "Previous studies had shown that patients continue to receive antibiotics for diagnoses where they may not be indicated, such as for a viral respiratory infection, especially in urgent care settings," said co-lead researcher Dr. Shirley Cohen-Mekelburg, an assistant professor of internal medicine at the University of Michigan Medical School. "Our findings reveal that this trend of inappropriate prescribing includes other classes of drugs -- including glucocorticoids -- and a variety of conditions," Cohen-Mekelburg added in a news release. For the study, published Tuesday in the Annals of Internal Medicine, researchers analyzed health care data for more than 22.4 million urgent care visits that occurred between 2018 and 2022. More than 12% of those visits resulted in a prescription for antibiotics, 9% in a steroid prescription and 1% in a scrip for opioids. The research team then looked to see how many prescriptions were handed out for health conditions the drugs aren't meant to treat. Among the inappropriate prescriptions, researchers found: Antibiotics prescribed for more than 30% of patients with ear infections, nearly 46% of patients with urinary symptoms and 15% of patients with bronchitis. Steroids prescribed for nearly 24% of patients with a sinus infection, 41% of patients with bronchitis and 12% of patients with upper respiratory infections. Opioids prescribed for nearly 5% of patients with muscle pain, more than 6% of patients with abdominal pain or GI symptoms and 4% of patients with sprains or strains. These results jibe with recent studies showing that urgent care is the most common type of health care visit to result in inappropriate prescriptions for antibiotics to treat viral respiratory infections, researchers said. The drugs are likely being handed out because the urgent care staff doesn't know better, patients are demanding specific meds and no one is providing back-up support for decisions about prescribing, researchers said. The consequences may be far-reaching: Antibiotic-resistant bacteria like MRSA have become a growing threat to health, due to the overuse of antibiotics. Likewise, America's opioid crisis has been fueled by too many painkiller prescriptions doled out for dicey reasons. Researchers concluded that drug stewardship programs are needed to make sure urgent care clinics are handing out the right drugs for the right conditions. "Reducing inappropriate prescribing of antibiotics, glucocorticoids and opioids will require a multifaceted approach," Cohen-Mekelburg said. "Providers at urgent centers would benefit from greater support and feedback in making these decisions." More information The Mayo Clinic has more on urgent care. Copyright © 2025 HealthDay. All rights reserved.
Yahoo
6 days ago
- Health
- Yahoo
What is chronic venous insufficiency? Everything to know about Trump's diagnosis
President Donald Trump has been diagnosed with chronic venous insufficiency, the White House announced on Thursday. Press Secretary Karoline Leavitt shared a letter from Trump's physician in a news conference, which said Trump was examined after he noticed "mild" swelling in his legs. Leavitt said the physician described the condition as "benign" and "common," particularly among adults above age 70. MORE: Gal Gadot reveals she had 'massive blood clot' in brain while pregnant Leavitt added that the president is in "excellent health" and that the doctor's full letter would be released soon. Here's what you need to know about the condition, what symptoms it causes and how it's treated. What is chronic venous insufficiency? Chronic venous insufficiency (CVI) is a circulatory condition in which the veins in the leg have difficulty returning blood back to the heart due to damaged valves. "Unlike the arteries, the veins have valves that help return blood to the heart," Dr. Andrea Obi, vascular surgeon at University of Michigan Health Frankel Cardiovascular Center and associate professor of vascular surgery at University of Michigan Medical School, told ABC News. She explained that there are larger veins, called deep veins, which return the bulk of blood to the heart, and there are superficial veins, which are just under the skin surface. "When the valves fail, meaning they don't adequately return blood to the heart, the blood can back up into the leg, and that's essentially what venous insufficiency is," Obi said. This can cause blood to pool in the legs and lead to leg swelling. MORE: Tori Kelly hospitalized: What you need to know about blood clots CVI is fairly common, affecting up to 40% of the U.S. population, according to the Society for Vascular Surgery. Obi said this figure may be an underestimation because CVI is not detected on any routine screening test, and patients often require a duplex ultrasound -- a non-invasive imaging technique to assess blood flow and blood vessel structure -- for diagnosis. What are the symptoms? Obi said most CVI patients have mild symptoms and the most common manifestation is varicose veins, which occur when the blood pools into the superficial veins just under the skin. The veins become swollen, which can be heavy, uncomfortable or painful for patients. If patients have CVI in the deeper veins, they may experience leg swelling around the ankle area and it can extend up towards the knee, Obi said. In more severe cases, darkening of the skin can occur and an open sore or ulcer could develop. "When the blood pools down near the ankle level, you'll get discoloration, and it's a brown discoloration … and that brown discoloration is the result of the iron from the red blood cells that sort of pools there and gets picked up by your immune cells," Obi said. Over time, this can make the skin thick and unable to heal from minor trauma, which is when ulcers form, she said. How is it treated? Treatments are typically nonsurgical and are mainly to prevent swelling and ulcers from forming, according to the Society for Vascular Surgery. Obi said if a patient is found to have CVI incidentally and they don't have symptoms, there is no need for treatment unless symptoms arise. First-line treatment can include compression, such as wearing compression stockings or an elastic wrap. There are also supplements patients can take to relieve symptoms, Obi said. MORE: Singer Tori Kelly being treated for multiple blood clots after collapsing "Compression is the very first thing that you prescribe and then, generally, if a patient desires surgical intervention or something like that, you would try compression first to see if they get relief," she said. "If they're still symptomatic or not able to live their daily life, then you might proceed down the pathway of doing an intervention to try and help them improve their quality of life." If superficial veins are affected, patients may receive vein ablation, which is a minimally invasive procedure to close the veins off, and removal of the varicose veins. If deep veins are affected, some patients may require an angioplasty to widen the narrow or blocked veins, or stenting to restore blood flow. Obi said even if someone's vein valves are prone to failing due to genetics or aging, walking can help overcome this. "Your calf muscle will substitute for your valves, and your calf muscle will actually push the blood back up to your heart," she said. "We tell all our patients, 'You should do some sort of walking program to keep that calf pump strong. The worst thing you can do is stand on your feet for long periods of time and allow the blood to pool."
Yahoo
6 days ago
- Health
- Yahoo
What is chronic venous insufficiency? Everything to know about Trump's diagnosis
President Donald Trump has been diagnosed with chronic venous insufficiency, the White House announced on Thursday. Press Secretary Karoline Leavitt shared a letter from Trump's physician in a news conference, which said Trump was examined after he noticed "mild" swelling in his legs. Leavitt said the physician described the condition as "benign" and "common," particularly among adults above age 70. MORE: Gal Gadot reveals she had 'massive blood clot' in brain while pregnant Leavitt added that the president is in "excellent health" and that the doctor's full letter would be released soon. Here's what you need to know about the condition, what symptoms it causes and how it's treated. What is chronic venous insufficiency? Chronic venous insufficiency (CVI) is a circulatory condition in which the veins in the leg have difficulty returning blood back to the heart due to damaged valves. "Unlike the arteries, the veins have valves that help return blood to the heart," Dr. Andrea Obi, vascular surgeon at University of Michigan Health Frankel Cardiovascular Center and associate professor of vascular surgery at University of Michigan Medical School, told ABC News. She explained that there are larger veins, called deep veins, which return the bulk of blood to the heart, and there are superficial veins, which are just under the skin surface. "When the valves fail, meaning they don't adequately return blood to the heart, the blood can back up into the leg, and that's essentially what venous insufficiency is," Obi said. This can cause blood to pool in the legs and lead to leg swelling. MORE: Tori Kelly hospitalized: What you need to know about blood clots CVI is fairly common, affecting up to 40% of the U.S. population, according to the Society for Vascular Surgery. Obi said this figure may be an underestimation because CVI is not detected on any routine screening test, and patients often require a duplex ultrasound -- a non-invasive imaging technique to assess blood flow and blood vessel structure -- for diagnosis. What are the symptoms? Obi said most CVI patients have mild symptoms and the most common manifestation is varicose veins, which occur when the blood pools into the superficial veins just under the skin. The veins become swollen, which can be heavy, uncomfortable or painful for patients. If patients have CVI in the deeper veins, they may experience leg swelling around the ankle area and it can extend up towards the knee, Obi said. In more severe cases, darkening of the skin can occur and an open sore or ulcer could develop. "When the blood pools down near the ankle level, you'll get discoloration, and it's a brown discoloration … and that brown discoloration is the result of the iron from the red blood cells that sort of pools there and gets picked up by your immune cells," Obi said. Over time, this can make the skin thick and unable to heal from minor trauma, which is when ulcers form, she said. How is it treated? Treatments are typically nonsurgical and are mainly to prevent swelling and ulcers from forming, according to the Society for Vascular Surgery. Obi said if a patient is found to have CVI incidentally and they don't have symptoms, there is no need for treatment unless symptoms arise. First-line treatment can include compression, such as wearing compression stockings or an elastic wrap. There are also supplements patients can take to relieve symptoms, Obi said. MORE: Singer Tori Kelly being treated for multiple blood clots after collapsing "Compression is the very first thing that you prescribe and then, generally, if a patient desires surgical intervention or something like that, you would try compression first to see if they get relief," she said. "If they're still symptomatic or not able to live their daily life, then you might proceed down the pathway of doing an intervention to try and help them improve their quality of life." If superficial veins are affected, patients may receive vein ablation, which is a minimally invasive procedure to close the veins off, and removal of the varicose veins. If deep veins are affected, some patients may require an angioplasty to widen the narrow or blocked veins, or stenting to restore blood flow. Obi said even if someone's vein valves are prone to failing due to genetics or aging, walking can help overcome this. "Your calf muscle will substitute for your valves, and your calf muscle will actually push the blood back up to your heart," she said. "We tell all our patients, 'You should do some sort of walking program to keep that calf pump strong. The worst thing you can do is stand on your feet for long periods of time and allow the blood to pool."
7 days ago
- Health
What is chronic venous insufficiency? Everything to know about Trump's diagnosis
President Donald Trump has been diagnosed with chronic venous insufficiency, the White House announced on Thursday. Press Secretary Karoline Leavitt shared a letter from Trump's physician in a news conference, which said Trump was examined after he noticed "mild" swelling in his legs. Leavitt said the physician described the condition as "benign" and "common," particularly among adults above age 70. Leavitt added that the president is in "excellent health" and that the doctor's full letter would be released soon. Here's what you need to know about the condition, what symptoms it causes and how it's treated. What is chronic venous insufficiency? Chronic venous insufficiency (CVI) is a circulatory condition in which the veins in the leg have difficulty returning blood back to the heart due to damaged valves. "Unlike the arteries, the veins have valves that help return blood to the heart," Dr. Andrea Obi, vascular surgeon at University of Michigan Health Frankel Cardiovascular Center and associate professor of vascular surgery at University of Michigan Medical School, told ABC News. She explained that there are larger veins, called deep veins, which return the bulk of blood to the heart, and there are superficial veins, which are just under the skin surface. "When the valves fail, meaning they don't adequately return blood to the heart, the blood can back up into the leg, and that's essentially what venous insufficiency is," Obi said. This can cause blood to pool in the legs and lead to leg swelling. CVI is fairly common, affecting up to 40% of the U.S. population, according to the Society for Vascular Surgery. Obi said this figure may be an underestimation because CVI is not detected on any routine screening test, and patients often require a duplex ultrasound -- a non-invasive imaging technique to assess blood flow and blood vessel structure -- for diagnosis. What are the symptoms? Obi said most CVI patients have mild symptoms and the most common manifestation is varicose veins, which occur when the blood pools into the superficial veins just under the skin. The veins become swollen, which can be heavy, uncomfortable or painful for patients. If patients have CVI in the deeper veins, they may experience leg swelling around the ankle area and it can extend up towards the knee, Obi said. In more severe cases, darkening of the skin can occur and an open sore or ulcer could develop. "When the blood pools down near the ankle level, you'll get discoloration, and it's a brown discoloration … and that brown discoloration is the result of the iron from the red blood cells that sort of pools there and gets picked up by your immune cells," Obi said. Over time, this can make the skin thick and unable to heal from minor trauma, which is when ulcers form, she said. How is it treated? Treatments are typically nonsurgical and are mainly to prevent swelling and ulcers from forming, according to the Society for Vascular Surgery. Obi said if a patient is found to have CVI incidentally and they don't have symptoms, there is no need for treatment unless symptoms arise. First-line treatment can include compression, such as wearing compression stockings or an elastic wrap. There are also supplements patients can take to relieve symptoms, Obi said. "Compression is the very first thing that you prescribe and then, generally, if a patient desires surgical intervention or something like that, you would try compression first to see if they get relief," she said. "If they're still symptomatic or not able to live their daily life, then you might proceed down the pathway of doing an intervention to try and help them improve their quality of life." If superficial veins are affected, patients may receive vein ablation, which is a minimally invasive procedure to close the veins off, and removal of the varicose veins. If deep veins are affected, some patients may require an angioplasty to widen the narrow or blocked veins, or stenting to restore blood flow. Obi said even if someone's vein valves are prone to failing due to genetics or aging, walking can help overcome this. "Your calf muscle will substitute for your valves, and your calf muscle will actually push the blood back up to your heart," she said. "We tell all our patients, 'You should do some sort of walking program to keep that calf pump strong. The worst thing you can do is stand on your feet for long periods of time and allow the blood to pool."
UPI
30-05-2025
- Health
- UPI
Eight times more young adults now take HIV prevention meds
More young Americans are taking antiretroviral meds to protect them from HIV infection than a decade ago. File Photo by John Angelillo/UPI | License Photo Eight times more young Americans are taking antiretroviral meds to protect them from HIV infection than a decade ago, a new study says. About 208 of every 100,000 U.S. young adults were using pre-exposure prophylaxis, or PrEP, to prevent becoming infected with HIV in 2023, researchers reported recently in the Journal of General Internal Medicine. That's up from 26 of 100,000 who filled a prescription for PrEP pills in 2016, researchers found in their analysis of data for 18- to 25-year-olds. "This is a patient population we often neglect in health care, because we don't think about them belonging to pediatric care or adult care, and their stage of cognitive development means they underestimate their STI [sexually transmitted infection] risk in general - yet they're one of the highest risk groups for a new diagnosis of HIV," said lead researcher Dr. Nina Hill, a general internist and pediatrician at the University of Michigan Medical School. "We're encouraged to see more prescribing over time, but the question remains: are we getting it to the highest-risk patients?" Hill added in a news release. For the study, researchers analyzed records on more than 1.4 million PrEP prescriptions dispensed to nearly 240,000 young adults between 2016 and 2023. The first PrEP medication, Truvada, was introduced in 2012 and became available as a generic drug in 2020, researchers said in background notes. A second oral option, Descovy, became available in 2019. The drugs reduce the chances of acquiring HIV through sex by 99%, when taken consistently as prescribed, researchers said. Nearly 9 of 10 (87%) of the prescriptions went to men, but Hill noted that some women also are at risk for HIV and could be eligible for PrEP. Unfortunately, results also showed that the length of time a person remained on PrEP declined by more than two weeks. This might indicate inconsistent use of PrEP, or show that young adults have trouble keeping up with the appointments and tests needed to continue the medication, researchers said. Nurse practitioners accounted for 39% of the prescriptions, while family doctors handed out 22% of the scrips, results show. Internists and physician assistants accounted for 14% and 11%, respectively. PrEP has been recommended since 2019 by the U.S. Preventive Services Task Force for teens and adults with an increased risk of acquiring HIV, researchers said. Under the Affordable Care Act, most insurance programs are required to make PrEP and HIV screening available to patients at no cost. However, the ACA's preventive care provisions are now under review at the U.S. Supreme Court, and a ruling is expected soon. More information The U.S. Department of Health & Human Services has more on pre-exposure prophylaxis. Copyright © 2025 HealthDay. All rights reserved.
