In the United States and other high-income countries, blood donation primarily relies on anonymous, voluntary donors. However, directed blood donation-where people donate for a specific recipient-has resurged, particularly due to misinformation surrounding COVID-19 vaccination. Requests for "nonvaccinated" blood, driven by misconceptions about vaccine safety, have led to legislative attempts to mandate compliance. Historically, directed donation was used to mitigate the risk for transfusion-related infections before modern screening techniques rendered it largely unnecessary. Today, it presents important patient safety risks, including increased infectious disease transmission, immunologic complications, and logistic burdens. Directed donations also introduce inefficiencies, diverting resources from the community blood supply and exacerbating shortages. Moreover, directed donation for nonmedical indications lacks scientific justification. Blood safety is ensured through rigorous donor screening, pathogen testing, and processing measures. There is no evidence that blood from vaccinated donors poses risk. Requests for nonvaccinated blood, as well as other directed donation preferences based on personal beliefs, introduce biases that are not grounded in medical necessity. Accommodating such requests undermines public trust in blood safety protocols and legitimizes unfounded fears. Ethical concerns arise as non-medically justified requests reinforce discriminatory practices, such as selecting donors based on race or gender. Allowing such preferences risks politicizing blood donation, spreading misinformation, and straining health care systems. Although autonomy is a core ethical principle in medicine, it does not justify non-evidence-based interventions. Given the potential harm and societal impact, directed blood donations should be limited to rare, medically necessary cases. Ongoing legislative efforts to mandate these requests require unified opposition from the medical and scientific community to uphold ethical, evidence-based, blood allocation practices.

Lyme disease, caused by Borrelia burgdorferi, is the most common vector-borne disease in the United States, and the range of its tick vector continues to expand. Most Lyme disease cases are diagnosed with the onset of the erythema migrans rashes, which can be single or multiple and vary from a homogeneous erythema to bull's-eye patterns. Serologic antibody testing is of low sensitivity at onset but becomes highly sensitive after a few weeks. Early dissemination may lead to neurologic and cardiac complications. Mono- or oligoarticular arthritis may develop in untreated patients. Antibiotic treatment is highly effective, but approximately 10% of treated patients experience persistent symptoms.

Current clinical practice uses a one-size-fits-all approach to define reference intervals for the results of diagnostic tests about thyroid function. This approach does not recognize subgroup differences according to age, sex, or race.

Long-term services and supports (LTSS) in the United States have faced substantial and enduring challenges. They encompass services for persons who can no longer independently care for themselves because of cognitive decline, functional limitations, chronic illness, or the sequelae of such conditions. These services are delivered in institutional and noninstitutional settings, such as nursing homes, assisted living facilities, and home- and community-based programs. This position paper by the American College of Physicians examines the ethical implications of current LTSS business models and practices and their effect on vulnerable persons receiving care in these settings. These models and practices include approaches to staffing, resource allocation, health equity, and attention to patient preferences and patient-centered care, as well as business strategies that focus on profit rather than patient care and ownership structures that can lack transparency and hinder accountability. Addressing these challenges necessitates a collaborative approach among policymakers, health care systems, researchers, physicians and other health care professionals, LTSS facility and agency owners, patients, and caregivers. By embracing shared goals through a collaborative approach, an LTSS system can be cultivated that optimizes ethical care, quality, and safety, ensuring respect for all individuals across their lifespan.

Patients with diverticulitis often attempt to control their diet with a particular focus on avoiding nuts and seeds. However, whether dietary patterns or dietary intake of nuts and seeds are associated with diverticulitis risk is poorly studied, particularly in women.

Type 1 and type 2 diabetes are prevalent chronic illnesses, are leading causes of mortality and morbidity, and result in substantial public health burden. Timely identification and appropriate management of diabetes can help reduce adverse consequences of diabetes. The American College of Physicians (ACP) embraces performance measurement as a means to improve quality of care but believes that a performance measure must be methodologically sound and evidence-based in order to be considered for inclusion in payment, accountability, or reporting programs. These principles are critical given the potential impact on physician administrative work, reputation, and reimbursement and to prevent unintended consequences for patient care. To help improve performance measurement and reduce burden, the ACP Performance Measurement Committee (PMC) reviews performance measures using a rigorous process to recognize high-quality measures and address gaps and areas for improvement. In this article, the PMC presents its review of 14 current performance measures for diabetes that are relevant to internal medicine. The PMC supports kidney health evaluation at the individual and group practice levels, hemoglobin A1c control at the health plan level, eye examination at the health plan level, and angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker therapy at the individual physician level.

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

Confirmatory testing to verify the diagnosis of primary aldosteronism (PA) in patients who have an abnormal screening result is of uncertain benefit.

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

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

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