Letter to the Editor

Dehydration: Therapeutic at the End of Life

To the Editor: Maintaining hydration is an important healthcare principle. Addressing patient hydration is an established goal in medicine.1 Physical and emotional health are enhanced by proper fluid and electrolyte balance. There also is a universal wish to extend enjoyable lives, but not to prolong unpleasant deaths.1–16 

Original Article

CME Article: Receiving Medical Care for Chronic Migraines: A Phenomenological Study

Objectives: Treating chronic migraine (CM) effectively is one of the greatest challenges a primary care provider (PCP) may encounter. Many patients with CM report dissatisfaction and minimal gains from treatment, despite using the best medical interventions available. For this study, patients with CM and their partners provided insight into how…

Posted in: Neurology15 Headache1

Original Article

Do Interviews Really Matter in Generating Programs and Applicants’ Rank Lists for the Match?

Objective: A paucity of data exists on the role of the interview day in programs and applicants’ final rank list. The objective of our study was to investigate the impact interview day has on our programs and our interviewees’ final rank list. Methods: For the 2020 appointment year, our program…

Original Article

CME Article: Pain after Arteriovenous Access Creation

Objectives: Dialysis access creation is a common outpatient procedure that can be completed using general, regional, or local anesthetic techniques. There are few endorsed guidelines regarding opioid-based pain control following fistula creation. The purpose of this study was to determine whether utilization of regional anesthesia (RA) is associated with the…

Posted in: Nephrology and Urology20

Original Article

Measures of Frailty in Homebound Older Adults

Objectives: Frailty, a geriatric syndrome associated with high morbidity and mortality, has rarely been assessed in homebound older adults. As such, we evaluated the prevalence of frailty among older adults enrolled in a home-based primary care program. b We measured frailty using the Fried Frailty Phenotype criteria of unintentional weight…

Posted in: Geriatric Syndromes6

Original Article

Disruption of Pediatric Emergency Department Use during the COVID-19 Pandemic

Objectives: There is evidence of substantial declines in pediatric emergency department (ED) utilization in the United States in the first several months of the coronavirus disease 2019 (COVID-19) pandemic. Less is known about whether utilization changed differentially for socioeconomically disadvantaged children. This study examined how changes in pediatric ED visits…

Posted in: Infectious Disease87

Multidisciplinary Clinical Case Study

When Statins Get Physical: A Curious Cause of Statin Myopathy

We present the case of a 61-year-old male with hyperlipidemia and lumbar radiculopathy admitted to our hospital with rhabdomyolysis attributed to the recent initiation of statin therapy. Despite aggressive fluid resuscitation and an initial declination in his creatine phosphokinase (CPK) levels, he had persistent myalgias with progressive weakness. Rheumatologic and…

Posted in: Autoimmune Systemic Disorders2 Diseases of Muscle & Neuromuscular Function1

Acknowledgment

Pandemic and the Art of Dying Well

Despite the enormous death toll of the coronavirus disease 2019 pandemic, conversations about dying well have been sidelined. Health practitioners have instead focused on public health mitigation strategies, therapeutic options, and outcome data. When we have spoken of dying, the conversation usually entails advance directive completion and dying alone as…

Posted in: Infectious Disease87

Editorial

The Crucial and Urgent Role of Family Physicians in Increasing COVID-19 Vaccinations

At the time of writing (August 2021), Arkansas, Louisiana, Mississippi, and Florida each recorded >500,000 new coronavirus disease 2019 (COVID-19) cases, making the southern United States the epicenter of the epidemic.1 At present, 85% of the public trust their family physicians as reliable sources of information on COVID-19.2 This editorial…

Posted in: Infectious Disease87

Original Article

COVID-19 Trials: Who Participates and Who Benefits?

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately afflicted vulnerable populations. Older adults, particularly residents of nursing facilities, represent a small percentage of the population but account for 40% of mortality from COVID-19 in the United States. Racial and ethnic minority individuals, particularly Black, Hispanic, and Indigenous Americans have…

Posted in: Infectious Disease87

Perspectives

Ethical Dilemma ECMO and COVID

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic >5.5 million deaths have been reported;1 however, the magnitude of its impact is much greater and runs far deeper. The unmeasurable effect on the global economy, the social implications, and the stress placed on an already fractured healthcare system have…

Posted in: Infectious Disease87

Perspectives

To Inform, Recommend, and Sometimes Persuade: The Ethics of Physician Influence in Shared Decision Making

Informed consent is broadly endorsed as a process that should facilitate shared decision making between a patient (or surrogate) and a physician (or other clinician). The goal of this collaborative process is to help patients make decisions that reflect what matters most to them, based on their guiding beliefs and…

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