Clinical » Patient Care

How Should a Hospitalized Patient with Newly Diagnosed Cirrhosis Be Evaluated and Managed?

The Case A 50-year-old man with no known medical history presents with two months of increasing abdominal distension. Exam is notable for scleral icterus, telangiectasias on the upper chest, abdominal distention with a positive fluid wave, and bilateral pitting lower-extremity edema. An abdominal ultrasound shows large ascites and a nodular liver consistent with cirrhosis. How… [Read More]

PHM16: Visual Clues Can Help Establish a Diagnosis

PHM16’s Visual Diagnosis: Signs and Why They Matter session led by Dr. Kenneth Roberts and guest presenters was a review of case presentations in which visual clues were vital to establishing a diagnosis. Though much of the content was presented with pictures, the emphasis was placed on the importance of correct diagnosis to avoid both… [Read More]

Alendronate Therapy Lowers Risk of Hip Fractures

NEW YORK – Long-term use of the bisphosphonate alendronate substantially lowers the risk of hip fracture without increasing the risk of atypical fractures of the subtrochanteric femur or femoral shaft, according to a Danish study. “These findings support an acceptable balance between benefit and risk with treatment with alendronate in terms of fracture outcomes, even for over 10 years of continuous… [Read More]

Medical Marijuana Cuts Medicare Spending and May Reduce Dependency on Prescription Opioids

Physicians wrote significantly fewer prescriptions for painkillers and other medications for elderly and disabled patients who had legal access to medical marijuana, a new study finds. In fact, Medicare saved more than $165 million in 2013 on prescription drugs in the District of Columbia and 17 states that allowed cannabis to be used as medicine, researchers calculated. If every state in… [Read More]

Active Surveillance is Safe Treatment Option for Low-Risk Prostate Cancer: PRIAS Study

NEW YORK – After a decade of follow-up in the Prostate Cancer Research International Active Surveillance (PRIAS) study, researchers have confirmed that active surveillance is a safe treatment option for men with low-risk prostate cancer. “However,” they say, “some changes could be made to the follow-up protocol to safely increase the number of men who remain on active surveillance.” Dr. Leonard… [Read More]

CAC Progression No Better Than Most Recent CAC Score: Study

NEW YORK – Progression of the coronary artery calcification (CAC) score over time predicts the risk of cardiovascular disease, but it performs no better than the most recent CAC score, according to findings from the Cooper Center Longitudinal Study (CCLS). “I must admit that I expected to find that the change in CAC was going to provide a lot of… [Read More]

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]

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]