Whether artificial intelligence (AI) assistance is associated with quality of care is uncertain.

Tirzepatide, a once-weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist approved for the treatment of adults with type 2 diabetes or obesity, showed clinically meaningful reductions in hemoglobin A1c (HbA1c) and body weight in the SURPASS phase 3 clinical trial program.

The American College of Physicians' Population Health and Medical Science Committee (PHMSC) developed this best practice advice to inform clinicians about what is currently known about the benefits and harms of cannabis or cannabinoids in the management of chronic noncancer pain and to provide advice for clinicians counseling patients seeking this therapy.

GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text] Pulmonology: [Formula: see text] Public Health: [Formula: see text].

Rural communities throughout the United States experience disparities in health and access to health care. Low population densities, isolating terrain, and vast geographic distances to other population centers create barriers to attracting and retaining physicians and other health professionals. The characteristics of rural communities also pose barriers to facilitating robust economic activity conducive to the production of health and the presence of health care facilities. As such, rural communities have faced high levels of hospital closures and "diseases of despair," such as opioid misuse and suicide. The heterogeneity of rural geographies and population characteristics produces unique and differing challenges across communities that require tailored policy interventions. Interventions that are culturally appropriate for rural communities must be adopted that address diseases and health conditions that impact rural populations and the related social and economic conditions that create and perpetuate these diseases and health conditions. Policymakers must invest in the economies, social services, and infrastructure of rural communities, especially those programs that provide health coverage and services to them. Ensuring access to telehealth is a critical component of expanding health care access. Medical education institutions and the medical community at large have a responsibility to equip physicians and physicians-in-training to care for rural communities and provide opportunities for trainees to practice in rural settings. These institutions must be supported through public policy that incentivizes the recruitment and retainment of a qualified physician workforce in rural communities.

GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text] Public Health: [Formula: see text].

During 2024, there were many practice-changing innovations in the field of endocrinology, particularly related to the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs). From the substantial new evidence published in 2024, 10 studies are highlighted that offer critical information for clinicians who manage or comanage patients with endocrine disorders including prediabetes, diabetes, obesity, and hyperparathyroidism. Two of the 10 articles are focused on use of GLP-1RAs in multiple clinical settings not studied in the original GLP-1RA trials, including after bariatric surgery and before endoscopy. Two additional studies focused on GLP-1RA explore the risk for thyroid cancer in patients prescribed GLP-1RA and the effect of a GLP-1RA on chronic kidney disease in patients with type 2 diabetes. Three articles investigate opportunities for deintensification of insulin frequency or an alternate method of insulin delivery in patients with type 2 diabetes. One article explores the cardiometabolic effects of intermittent fasting in persons with prediabetes and type 2 diabetes. The last 2 articles explore the incidence of diabetes after SARS-CoV-2 infection and the skeletal effects of parathyroidectomy as a treatment of hyperparathyroidism. The results of each study have a direct effect on the delivery of care for patients with prediabetes, type 2 diabetes, and hyperparathyroidism.

There have been many recent advancements in cardiology research, with numerous studies published across the multiple subspecialties. Having screened more than 1200 articles published in 2024, we summarize 10 studies in this article that highlight key changes in this field. Starting with atrial fibrillation (AF), we note articles that examine which patients benefit most from catheter ablation, a procedure that is becoming increasingly common. We then examine new evidence regarding anticoagulation in device-detected AF and in patients with AF and coronary disease. In patients with severe aortic stenosis, the timing of valve intervention in relation to development of symptoms was a hot topic and is addressed here. There have also been developments in treatment of heart failure with preserved ejection fraction, including research into medications such as finerenone and tirzepatide. Certain studies attempt to challenge our current medical practices, including routine use of β-blockers after myocardial infarction (MI) and holding of renin-angiotensin system inhibitors before noncardiac surgery. Finally, the role of invasive treatment strategies for older adults with non-ST-segment elevation MI has also been addressed.

GIM/FP/GP: [Formula: see text] Infectious Disease: [Formula: see text] Critical Care: [Formula: see text].

GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Endocrinology: [Formula: see text].

Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Critical Care: [Formula: see text].

This article highlights selected major advances in gastroenterology and hepatology from 2024 that are relevant for internal medicine specialists. In colorectal cancer (CRC) screening, new developments include a head-to-head comparison of different fecal immunochemical tests and a new blood-based DNA screening test, benefits and harms of artificial intelligence-assisted colonoscopy, and adenoma detection rate improvement and risk for cancer. Treatment options for metabolic dysfunction-associated steatotic liver disease now include resmetirom, a recently approved drug for treatment of patients with moderate-to-severe fibrosis, and liver transplantation may now be an option in patients with unresectable colorectal liver metastases. Also featured are new data on the efficacy of indomethacin and pancreatic stent placement for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography and news on the efficacy and safety of zastaprazan, a new potassium-competitive acid blocker for reflux esophagitis. Finally, a recent randomized trial is highlighted that has dispelled concerns about potential harms of proton-pump inhibitors for stress ulcer prophylaxis in patients receiving invasive mechanical ventilation.

GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text].

Emergency Med: [Formula: see text] GIM/FP/GP: [Formula: see text] Cardiology: [Formula: see text] Critical Care: [Formula: see text] Pulmonology: [Formula: see text].

Obesity is a leading cause of morbidity and mortality with health consequences that crosscut most medical specialties. Despite the emergence of effective and promising new therapies, many impediments to comprehensive obesity care remain. As part of their commitment to improving obesity care, the American College of Physicians (ACP) and its Council of Subspecialty Societies (CSS) held a summit on 24 October 2023 to identify barriers to and opportunities for collaborative action in the domains of physician education, health care policy and care delivery, and addressing weight bias. This report summarizes the summit proceedings and provides a postsummit synthesis from ACP and CSS. Key themes were centered on knowledge, advocacy, action, and compassion, including the need for culture change, paradigm shifts, and stakeholder engagement and collaboration; a focus on empowerment of both clinicians and patients; the importance of knowing patients as people to help address social determinants of health; the need to address learned helplessness; and the importance of embracing artificial intelligence and technology as disruptive innovations. Recommendations for next steps for collaborative action include leveraging and improving already available educational and clinical resources, developing obesity education and care standards that incorporate patients' perspectives and address social determinants of health, developing community and public-private partnerships to improve access and public awareness, and coordinating messaging and policy advocacy efforts that align with mitigating the longstanding obesity epidemic.

This article highlights some important nephrology studies published in 2024 that may be relevant for nonnephrologist physicians. Four studies examined progression of chronic kidney disease (CKD), cardiovascular events, and nephrolithiasis with respect to use of semaglutide or sodium-glucose cotransporter-2 inhibitors. Three studies examined treatments to improve specific aspects of CKD management, including mineralocorticoid receptor agonists to address heart failure, avenciguat to address albuminuria, and oral phosphate binders to address fracture risk. One study demonstrated that inorganic nitrate reduced the risk for contrast-induced nephropathy. Finally, a trial of cefepime-taniborbactam showed benefit for treating complicated urinary tract infection.

The past year saw many important publications in the specialty of pulmonology. We screened more than 750 articles published in 2024 and carefully selected 10 that feature important advancements in the management of several respiratory conditions. We highlight 4 articles that describe management options for patients with chronic obstructive pulmonary disease (COPD) beyond pharmacotherapy, including breathing techniques, duration of long-term oxygen therapy, high-intensity compared with low-intensity noninvasive ventilation for exacerbations, and the potential harmful effect of gabapentinoids. Two articles delved into the evidence for various biologic therapies and inhaled relievers used in asthma. We include a randomized trial examining treatment of acute eosinophilic COPD and asthma exacerbations with benralizumab. One article explores dual glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptor agonists as a novel treatment option for obstructive sleep apnea. Another discusses the efficacy of inhaled antibiotics in bronchiectasis. Finally, a meta-analysis examines the evidence for postexposure prophylaxis antiviral agents to reduce transmission and severity of influenza infections.

Long-term (≥12 months) randomized trials evaluating the efficacy of intermittent fasting (IMF) as a dietary weight loss strategy are limited. Furthermore, no studies have compared IMF versus daily caloric restriction (DCR) when both interventions are provided in the context of a guidelines-based behavioral weight loss program.