She is always a difficult admission. The long chart review. The vague complaints. The entitled attitude. The misdirection. These are expected. As is the cake at her bedside after a diabetic crisis. The two-liter soda after an emergent fluid dialysis. The urine toxicology was positive for cocaine. The staff knows her well. I know her well. I give her the attention, kindness and empathy that I give to every patient. ...

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It’s been a long day, and you just want to decompress. My boyfriend tells me about his day. I get to hear about the insane amount of reading he has to do for graduate school, or about the occasional annoying customer he’s had to deal with at his part-time job as a bank teller. When it’s my turn to decompress, I usually gripe about a patient or two from the ...

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medpagetodayFrom MedPage Today:

  1. Diabetes Patients on BP Meds at Lower Risk. Lowering blood pressure in patients with type 2 diabetes was associated with decreased mortality risk in a meta-analysis of 40 randomized trials.
  2. ACA: Beyond 'Repeal And Replace'. Repeal and replace" has been the rallying cry for Republicans since the Affordable Care ...

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Why is it so hard to make a dent in the huge volume of unnecessary health care? In the U.S., about 20 to 30 percent of the medical interventions American patients receive are useless and often harmful, and waste hundreds of billions of dollars each year. Insurers have known this for decades. These days, many more doctors have begun to see the big picture, along with policy makers.  But the ...

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medpagetodayFrom MedPage Today:

  1. Exposure to Secondhand Smoke Cut in Half. The number of people exposed to secondhand smoke dropped by half over the last decade, but one in four nonsmokers, or some 58 million people, are still exposed.
  2. Patients Mum on Work-Related Asthma. While 46% of employed adults had asthma that was ...

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medpagetodayFrom MedPage Today:

  1. Is This Tattoo Worth a 1,000 Needle Pricks? Researchers at the University of California San Diego believe they have a feasible, noninvasive method for monitoring serum glucose: a temporary tattoo.
  2. Systolic Pressure Signals Risk in Young. Isolated systolic hypertension in young and middle-age adults was associated with an increased ...

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medpagetodayFrom MedPage Today:

  1. NSAIDs Linked to Leaks After GI Surgery. Postoperative nonsteroidal anti-inflammatory drug (NSAID) use was associated with anastomotic leak after nonelective colorectal surgery.
  2. More Nurses May Mean Fewer Deaths in ICU. A high nurse to patient ratio in intensive care units was independently associated with a lower risk of in-hospital ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old man is evaluated in the emergency department for a 3-day history of fever and chills as well as confusion. He has a 5-week history of a nonhealing ulcer on the plantar surface of his left foot. He has diabetes mellitus, hypertension, and peripheral vascular disease for which he takes metformin, ...

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medpagetodayFrom MedPage Today:

  1. Managing Diabetes in Elderly: How Safe? Many older people with diabetes who have compromised health have been kept on intensive treatment regimens, which increases the risk of hypoglycemia.
  2. Supreme Court Battle Brewing Over Medicaid Fees. Rita Gorenflo's 7-year-old son Nathaniel was in severe pain from a sinus infection.

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medpagetodayFrom MedPage Today:

  1. Whole Grains Reduce CVD, Total Death Risk. Eating a diet rich in whole grains was found to be associated with lower total mortality and deaths from cardiovascular disease (CVD), but not cancer.
  2. Tight Control Lowers Death in Type 1 Diabetes. Tight glucose control has a legacy effect of reduced ...

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