H. pylori treatment, suicide prevention, and more stories

Helicobacter pylori is tricky to treat and becoming only more so given rising antibiotic resistance. Previous first-line regimens, for example, now have an eradication rate of only 70%. In light of this shifting landscape, the American College of Gastroenterology recently updated its clinical guideline on H. pylori treatment, with recommendations including preference for optimized bismuth quadruple therapy in treatment-naive patients when antibiotic susceptibility is unknown. Our story reviews the new guidance and offers tips on ensuring eradication therapy is successful.

Primary care is a common touchpoint for patients who have suicidal ideation, with research showing that 45% of those who die by suicide visit their physician in the 30 days before their death. While federal guidelines don't yet recommend universal screening for suicide risk, there are steps primary care physicians can take to help intervene. Our story reviews a new model or two, examines potential high-risk groups, and offers advice on talking with patients.

Finding a first job or a new job as an early career physician is exciting but can be overwhelming, too. After an extended period where next steps have been mapped out by others, those just starting out may have a bit of a learning curve when determining which jobs fit their short-term and long-term professional goals. Our I.M. Ready feature offers resources to help, including advice from experts on narrowing down exactly what you want from your next position.

Our conference coverage in this issue is from IDWeek, which was held in Los Angeles in October 2024. Life expectancies for people living with HIV have increased over the past few decades, which means that more women with HIV are going through menopause. At the meeting, an expert offered three reasons for physicians to include menopause care in their HIV care toolkits and highlighted advice on symptom management and drug-drug interactions, among other topics.

In this issue's Pearls from I.M. Peers, Joy Bulger Beck, MD, MS, FACP, describes her evidence-based method for determining when to repeat testing for osteoporosis after an initial bone density test. Guidelines are vague on this point, but looking at a patient's initial results and risk factors can help a clinician pinpoint the right timeframe, as Dr. Bulger Beck explains.

Finally, ACP's Chair of the Board of Regents, William E. Fox, MD, MACP, details his decades of involvement with the College and explains why perseverance is needed to make progress on priorities, while our Chief Advocacy Officer reviews the current political landscape and offers suggestions on living through unprecedented times.

What do you think about the new H. pylori guidance? When do you repeat DEXA testing in your practice? Let us know at immattersacp@acponline.org.

Sincerely,

Jennifer Kearney-Strouse
Executive Editor