Clinical

Persistent Fatty Liver Increases Risk of Carotid Atherosclerosis

NEW YORK – Patients with persistent nonalcoholic fatty liver disease (NAFLD) face a significantly elevated risk of carotid atherosclerosis, according to a new study of Korean men. “The most interesting finding of our research is that regression of fatty liver is associated with reduced risk of subclinical carotid atherosclerosis compared to persistent fatty liver,” said Dr. Geum-Youn Gwak from Sungkyunkwan University School… [Read More]

CT Scans Reliable Determinants of Blunt Trauma

NEW YORK – CT scans identify all clinically significant cervical spine injuries in intoxicated patients with blunt trauma, according to a new study. “I don’t think any of the results were particularly surprising to any of us who regularly do trauma care, but what I do think is remarkable about them is that they dispel several long-held myths about the… [Read More]

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Is It Safe to Discharge a Patient with IDU History, PICC for Outpatient Antimicrobial Therapy?

Case A 42-year-old female with a history of intravenous (IV) drug use presents with severe neck pain, gait instability, and bilateral C5 motor weakness. A cervical MRI shows inflammation consistent with infection of her cervical spine at C5 and C6 and significant boney destruction. The patient undergoes kyphoplasty and debridement of her cervical spine. Operative… [Read More]

LETTER: Point-of-Care Ultrasound: The (Sound) Wave of the Future for Hospitalists

Small devices carried in pockets during rounds can enable hospitalists to make quick decisions at the bedside, enhance and teach physical exam skills, streamline patient flow through the hospital, and potentially avoid the cost and risk of exposure to radiation. Point-of-care (POC) ultrasound enhances both patient satisfaction and the clinician’s professional satisfaction. Hospital medicine will… [Read More]

Metformin Continues to Be First-Line Therapy for Type 2 Diabetes

Clinical question: Which medications are most safe and effective at managing type 2 diabetes? Background: Patients and practitioners need an updated review of the evidence to select the optimal medication for type 2 diabetes management. Study design: Systematic review. Synopsis: The authors reviewed 179 trials and 25 observational studies. When comparing metformin to sulfonylureas, metformin… [Read More]

Reevaluating Cardiovascular Risk after TIA

Clinical question: What is the prognosis of patients who have a TIA or minor stroke? Background: Prior studies had estimated the risk in the three months following a TIA or minor stroke of having a stroke or acute coronary syndrome (ACS) as 12% to 20%, but this may not reflect the risk of modern patients… [Read More]

Successfully Quitting Smoking May Take Many Attempts

Though conventional wisdom says it takes five to seven attempts for most smokers to quit, those estimates may be very low, a recent study suggests. Based on data for more than 1,200 adult smokers in Canada, the real average number of quit attempts before succeeding may be closer to 30. “For so long we’ve been… [Read More]

Protein-Based Risk Score Improves Prediction of Cardiovascular Events

NEW YORK – A new protein-based risk score outperforms the Framingham model for predicting cardiovascular outcomes in patients with stable coronary heart disease. “Patients who carry the diagnosis of stable coronary heart disease have been viewed traditionally as a homogeneous population within which all individuals tend to be treated similarly,” Dr. Peter Ganz, from the… [Read More]

Effective Applications of Medication-Assisted Opioid Dependence Counseling

NEW YORK – Patients dependent on prescription opioids are likely to quit if they get individual drug counseling with their prescribed medications, according to long-term follow-up results. “Medication-assisted treatment for opioid dependence benefited people who were dependent on prescription opioids. Good standard medical management, medically based counseling, can be effective for these people if given in conjunction with buprenorphine treatment,” said lead… [Read More]

New HCV Diagnostic Tests Provide Accuracy and Low Costs

NEW YORK – Several hepatitis C virus core antigen (HCVcAg) tests accurately diagnose hepatitis C virus (HCV) infection and could replace nucleic acid testing (NAT) in settings where HCV is prevalent, according to a systematic review and meta-analysis. “Overall, several of the tests perform very well and while they are not equal to NAT, the lower costs may improve diagnostic capacity… [Read More]