Objectives: To update trends in the rates of ectopic pregnancy, to compare rates of ectopic pregnancy between commercially insured and Medicaid-insured women, and to assess the differences in rates of ectopic pregnancy by different measures of ectopic pregnancy. Methods: We analyzed data from 2002 to 2013 using the Truven Health…
To the Editor: A patient who presented with diarrhea was diagnosed as having inflammatory bowel disease. His gastroenterologist prescribed budesonide, a nonabsorbable glucocorticoid that was patented in 1965. A 1-month supply of the generic version of this drug was offered by his pharmacist at a cost of $968.
I commend Fuentes and colleagues of the University of Florida for their outstanding review of the approach to the cancer survivor’s transition back to the care of his or her primary healthcare provider, “Cancer Survivor’s History and Physical,” which is published in this issue of the Southern Medical Journal.1 The…
The number of cancer survivors is estimated by 2022 to increase to almost 18 million, in part because of improvements in earlier detection and cancer therapies, leading to longer-term survival of cancer patients. This growing number of survivors has presented challenges to the healthcare community, one of which is the…
Objectives: Meta-analyses based on peer-reviewed publications report a sensitivity of approximately 85% for rapid antigen streptococcus tests to diagnose group A streptococcal (GAS) pharyngitis. Because these meta-analyses excluded package inserts, we examined the test characteristics of rapid antigen streptococcal tests and molecular methods that manufacturers report in their package inserts….
Objectives: The majority of Americans diagnosed as having cancer are older than 65 years. They are, however, less likely than younger patients to receive chemotherapy. Our study aimed to better understand the specific reasons for acceptance or refusal of chemotherapy in older adults with cancer. Methods: An anonymous cross-sectional survey…
Federman and Gunderson have provided a cogent analysis of the technique of battlefield acupuncture, also known as auricular acupuncture and rapid acupuncture.1 The authors describe the intent of the technique as well as the supporting evidence to date regarding its efficacy. They conclude that “presently the amount and quality of…
Objectives: The superior performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis and staging of malignancy has been demonstrated, with some investigators suggesting the same for sarcoidosis. The role of EBUS-TBNA in the diagnosis of histoplasmosis is not clear, however. In this study we estimate the diagnostic yield…
Psoriasis treatments range from topical treatments and phototherapy to oral systemic medications and injections. Despite good control of the disease when applying appropriate treatments (according to disease severity, insurance parameters, patient preference, and patients’ ability to adhere), continued advancements will allow even better symptomatic control, reduced adverse effects, and patient…
Objectives: Studies have shown that the overutilization of laboratory tests (“labs”) for hospitalized patients is common and can cause adverse health outcomes. Our objective was to compare the ordering tendencies for routine complete blood counts (CBC) and chemistry panels by internal medicine residents and hospitalists. Methods: This observational study included…
To the Editor: We read Dr Richards’s comments with great enthusiasm. Regarding the differences observed between cocaine-positive and cocaine-negative patients receiving β-blockers, there was a significantly lower number of cocaine-positive patients receiving β-blockers at the time of discharge. That said, compared with the time of admission, the cocaine-positive group had…
The use of prescription opioids for chronic pain has increased markedly within the past few decades; thus, death rates associated with opioid overdoses have increased dramatically. Nonopioid pharmacologic therapies also are associated with adverse effects. Other pain-abatement modalities such as acupuncture may be useful in the treatment of several painful…
To the Editor: I enjoyed reading the outstanding study on the management of cocaine-induced myocardial infarction by Chibungu and colleagues.1 I would like to comment specifically on the differences observed between cocaine-positive versus cocaine-negative patients receiving β- blockers.
The issue of physician aid in dying (PAD) has been front and center in the media, with the state of California on June 9, 2016, legalizing the writing of a lethal prescription for patients with terminal illness. California has joined Oregon, Washington, Vermont, and Montana as states where PAD is…
Objectives: Tenure policies in US medical schools have been under scrutiny for decades while black/African American, Latino, and Native American faculty continue to be underrepresented in medicine. As medical institutions seek to improve diversity, tenure continues to be a major retention tool. We undertook a systematic review of the literature…
Much attention is placed on documenting and, one hopes, obtaining, informed decisions in medical settings. We answer questions and sign forms requesting permission for things as varied as sharing personal health information, receiving annual flu shots, and undergoing aneurism repair. Institutional review boards, the organizations tasked with protecting research patients’…
Diagnostic blood loss is known to have a significant effect on the occurrence of hospital-acquired anemia (HAA).1 Furthermore, HAA is common and is associated with increased mortality and resource utilization.2 In this issue of the Southern Medial Journal, Ellenbogen and colleagues report significantly higher self-reported and actual use of complete…
Objectives: We examined Adventist Health System (AHS)–affiliated providers and staff regarding controversial spiritual practices such as praying led by a practitioner, sharing of personal religious beliefs, and encouraging patients’ religious beliefs for health reasons. Methods: Approached were 1082 providers to participate in a project to integrate spirituality into outpatient care….
Most research correlates religion with health outcomes positively, and there is growing interest in integrating spirituality into medical practice, particularly in the areas of oncology1 and mental health.2 The question of how to integrate spirituality with medical care remains controversial, however, and little data exist about attitudes and practices within…
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