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Cannabis use is on the rise among individuals with diabetes, with a 33.7% increase in usage between 2021 and 2022. This trend is observed across different age groups, including those over 65 years old. Despite the increasing prevalence of cannabis use, there is limited evidence available due to its classification as a schedule I drug in the United States. As legalization progresses, endocrinologists may encounter more patients seeking guidance on cannabis use, highlighting the need for further research in this area. [Extracted from the article]

In 2022, approximately 22% of individuals who died from drug overdoses had a mental health disorder unrelated to substance use, according to data from the CDC. The study analyzed data from 43 states and the District of Columbia, identifying common mental health disorders such as depression, anxiety, and bipolar disorder among overdose victims. The findings highlight the importance of integrating mental health care into overdose prevention efforts, emphasizing the need for screening and treatment for substance use disorders and other mental health conditions. [Extracted from the article]

A recent study published in JAMA has found that certain commonly prescribed oral antibiotics are associated with potentially life-threatening cutaneous adverse drug reactions (cADRs). The study, which spanned two decades and focused on older adults, emphasizes the importance of judicious prescribing and the use of antibiotics with lower risk when clinically appropriate. The most strongly associated antibiotic class with serious cADRs was sulfonamides, but all other antibiotic classes, including cephalosporins, nitrofurantoin, penicillins, and fluoroquinolones, were also associated with an increased risk. The study also revealed previously unreported findings about nitrofurantoin, which is commonly prescribed for urinary tract infections and was found to be associated with an increased risk of severe drug rash. [Extracted from the article]

A recent study published in JAMA Surgery found that older adults who had a primary care visit within 90 days after cancer surgery had a significantly lower 90-day mortality rate compared to those without a visit. The study included 2,566 patients aged 65 years or older who underwent inpatient cancer surgery between 2017 and 2019. Patients without a primary care practitioner had a higher 90-day postoperative mortality rate than those with a primary care practitioner. The study suggests that identifying older cancer patients without a primary care practitioner before surgery could be an intervention point to improve outcomes. However, it is important to note that the study was retrospective and performed at a single institution, which may limit the generalizability of the results. [Extracted from the article]

A recent study explored the use of wearable devices and mobile apps to help manage chronic obstructive pulmonary disease (COPD). The study found that patients with COPD found the wearable device and app useful in managing their condition. The app provided reminders for self-care, predicted early exacerbations, and facilitated communication with healthcare providers. Participants reported that the feedback they received through the app was useful, particularly in terms of reassurance and feedback about stable vitals during exercise. However, there were some technical difficulties and suggestions for improvement, such as adding more health information to be tracked. The study suggests that wearable devices and apps have the potential to improve patient empowerment and lifestyle changes for individuals with COPD. However, it is important to consider equity and ensure that individuals with lower digital literacy or financial insecurity are not left behind. Further research is needed to examine how these technologies can improve care for patients with COPD. [Extracted from the article]

CVS Health has launched an initiative that uses technology to provide weather alerts and targeted outreach to individuals at increased risk due to climate and weather conditions. The goal of the initiative is to improve health outcomes, reduce emergency department visits, hospital stays, and medical costs. The program initially focuses on extreme heat events and will expand to include alerts about high levels of air pollution. The alert system uses environmental data analytics to provide personalized tips and resources to high-risk patients. However, it is important to consider the comprehensive needs of vulnerable patients, including access to medications and climate-controlled settings. [Extracted from the article]

A recent case study published in JAMA Internal Medicine highlights the importance of closely monitoring medication dosing in patients experiencing rapid weight loss. The case involved a 62-year-old man who developed atrial fibrillation due to the failure to adjust his levothyroxine dose after significant weight loss while taking the antiobesity drug tirzepatide. The patient's thyrotropin level dropped to a dangerously low level, leading to thyrotoxicosis and an increased risk of atrial fibrillation. The authors emphasize the need for careful monitoring and dose adjustments for weight-based medications, particularly in older patients with comorbidities and polypharmacy. They also caution against the unsupervised use of weight loss medications and stress the importance of collaboration between patients and clinicians throughout treatment. [Extracted from the article]

A review of studies conducted by investigators has found that strict sodium intake, with or without fluid restrictions, is unlikely to provide clinical benefits for patients with heart failure. In fact, moderate daily intake of sodium (3.0-4.5 g) may improve the quality of life and functional status of these patients, even though it may not improve life expectancy or hospitalization rates. Excessive fluid restriction also does not reduce mortality or hospitalization rates and can cause unnecessary strain and pain for patients. However, it is important to consider individual factors such as comorbidities, kidney disease, and demographic characteristics when determining sodium intake. [Extracted from the article]

This article discusses the connection between Olympic athletes and their success in the field of medicine. It highlights four athletes who became high-performing physicians and explores how their athletic training contributed to their achievements in medicine. The athletes-turned-physicians credit skills such as time management, teamwork, goal setting, and a strong work ethic, which they developed as elite athletes, as key factors in their success in medicine. The article emphasizes the importance of perseverance, resilience, and the ability to handle setbacks in both athletics and medicine. [Extracted from the article]

This article discusses the identification and treatment of Lyme disease in primary care. The geographic spread of ticks that cause Lyme disease in the United States has led to an increase in cases, with 476,000 new cases reported each year. The article provides information on identifying the bite and the diagnostic markers for Lyme disease. It also discusses testing steps and treatment options. The article emphasizes the importance of early diagnosis and treatment for a favorable outcome. The authors also address challenges in diagnosing Lyme disease, such as distinguishing it from other conditions and considering it in non-endemic areas. The article concludes by highlighting the role of primary care physicians in evaluating and treating early cases of Lyme disease. [Extracted from the article]

Brighter Days Pediatric Mental Health Urgent Care Center in Rochester, New York, is a new walk-in clinic that offers rapid assessment, crisis intervention, and short-term stabilization for children and adolescents experiencing mental health crises. Similar walk-in facilities are emerging in several states, providing a bridge between traditional outpatient services and emergency room visits for young people with mental health concerns. The urgent care centers aim to provide specialized care in a more appropriate setting than an emergency room, which can be overwhelming for patients. However, there are challenges such as staffing shortages and the need for appropriately trained mental health professionals. [Extracted from the article]

A study conducted in Chelsea, Massachusetts, examined the effects of cash supplementation on healthcare utilization and outcomes. The study randomly selected individuals to receive cash benefits through a government program during the pandemic. The results showed that those who received cash benefits had fewer emergency department visits, particularly for substance use disorder, compared to those who did not receive benefits. However, there was a slight increase in outpatient visits, mainly for specialty care. Overall, the program saved about $450 per person in healthcare costs over 9 months. The study suggests that addressing poverty may improve health outcomes. [Extracted from the article]

A new clinical practice update from the American Gastroenterological Association (AGA) emphasizes the importance of recognizing and treating cyclic vomiting syndrome (CVS). CVS is a chronic disorder characterized by sudden episodes of intense nausea, vomiting, and retching, followed by symptom-free periods. It affects up to 2% of U.S. adults, with higher prevalence in women, young adults, and those with a personal or family history of migraines. The update aims to increase awareness of CVS among healthcare providers and reduce diagnostic delays. It provides guidance on diagnosis, management, and treatment strategies for CVS patients. [Extracted from the article]

German emergency rooms are facing overcrowding and long wait times due to patients without urgent medical emergencies seeking treatment. Dr. Norbert Schütz, director of geriatrics and rheumatology at Helios Dr. Horst Schmidt Hospital, emphasized the importance of correctly assessing medical situations and educating the public on when to seek emergency care. The German Society of Internal Medicine aims to educate patients on recognizing emergencies, particularly in children and mental illnesses. A study found that only 4 out of 10 patients in emergency rooms had genuine emergencies, with reasons for visiting the emergency room ranging from structural conditions to patient preferences. [Extracted from the article]

This article discusses the effects of climate change on respiratory health, specifically focusing on two conditions: platanus cough and thunderstorm asthma. Platanus cough is caused by the fine hair found on platanus leaves, bark, branches, and buds, which can break off and cause symptoms such as shortness of breath and coughing. Thunderstorm asthma occurs when thunderstorms and lightning cause large pollen grains to break apart and enter the lower airways, triggering acute asthma attacks. The article emphasizes the importance of understanding and preparing for these conditions, including individual precautions and public health strategies. [Extracted from the article]

A recent trial called TELE-ACS found that patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) had significantly lower rates of hospital readmission and emergency department visits if they participated in a remote monitoring protocol compared to those who received standard post-discharge care. The telemedicine protocol included consultation with a cardiologist who reviewed home-monitoring data. The study also showed lower rates of unplanned coronary revascularizations and cardiovascular symptoms in the telemedicine group. However, the rates of major adverse cardiovascular events (MACE) were similar between the two groups. The study suggests that telemedicine can be effective in reducing rehospitalization and revascularization in post-PCI ACS patients. [Extracted from the article]

A primary care shortage in the United States is making it increasingly difficult for patients to access the care they need. Many Americans do not have a regular source of care, and those looking for a new primary care provider face long wait times for appointments. The shortage of primary care providers is expected to worsen in the coming years, with a projected shortage of 68,000 providers by 2036. The current fee-for-service model and administrative burdens are contributing to the shortage, and experts suggest that higher reimbursement rates and restructuring the payment system could help address the issue. In the meantime, primary care doctors are adapting by reducing their hours, transitioning to concierge services, or specializing their practice. Efforts are also being made to improve access to primary care through workplace initiatives. However, more significant reforms are still needed to adequately address the primary care shortage in the United States. [Extracted from the article]

A recent study published in JAMA Network Open suggests that adults who were discharged from the hospital with medication for alcohol use disorder (MAUD) were 51% less likely to be rehospitalized for an alcohol-related issue. However, despite the known efficacy of MAUD, only 2% of patients were discharged with a prescription for it. The researchers emphasize the need to increase access to these medications upon hospital discharge. The study was funded by various institutions and organizations. [Extracted from the article]

A large prospective study found that antibiotics have no measurable effect on the severity or duration of coughs caused by acute lower respiratory tract infection (LRTI). In fact, patients who received antibiotics had a slightly longer illness duration compared to those who did not receive antibiotics. The study supports the reduction of antibiotic prescriptions for LRTIs. Patients often have unrealistic expectations about the effectiveness of antibiotics, and efforts should be made to educate them about the appropriate use of antibiotics. Overuse of antibiotics can lead to adverse effects and contribute to antimicrobial resistance. Further research is needed to determine if there is a limited role for antibiotics in treating coughs. [Extracted from the article]

The article discusses the development of the geriatric emergency medication safety recommendations (GEMS-Rx), which is a list of high-risk medication classes that should not be prescribed to older patients visiting the emergency department (ED). The GEMS-Rx list was created by a panel of 10 ED physicians and a pharmacist with expertise in geriatric pharmacotherapy and emergency medicine. The list includes medications such as benzodiazepines, skeletal muscle relaxants, barbiturates, antipsychotics, antihistamines, and certain other drugs. However, there are exceptions for specific cases such as seizure disorders, benzodiazepine withdrawal, and end-of-life care. The authors suggest that the GEMS-Rx list can be used as a resource to guide prescribing decisions and improve patient safety in EDs. [Extracted from the article]

A recent study found that routine use of rapid viral testing in emergency departments (ED) has limited benefits for patients with acute respiratory infections (ARI). The study showed that viral testing did not reduce antibiotic use, ED length of stay, or rates of ED return visits or hospitalization. However, it was associated with a small increase in antiviral prescriptions and a small reduction in blood tests and chest x-rays. The researchers concluded that rapid viral testing should be reserved for high-risk patients or those with severe disease. Further research is needed to explore the impact of newer-generation panels and respiratory pathogen panel testing. [Extracted from the article]

Melatonin, a hormone produced by the body to regulate sleep, has become a popular sleep aid for children. While it can be beneficial for children with certain conditions, such as ADHD or autism, the increased use of melatonin among healthy populations has led to a rise in accidental ingestion among young children. According to recent data from the CDC, there has been a significant increase in poison center calls and emergency department visits related to pediatric melatonin exposures. Experts emphasize the need for increased awareness and safety measures to protect young children from unintentional overdose. The American Academy of Sleep Medicine advises parents to approach melatonin with caution and suggests focusing on developing good sleep habits instead. It is recommended to consult a pediatrician before using melatonin and to start with the lowest possible dose. However, it is important to note that melatonin supplements are not regulated by the FDA, and the actual amount of melatonin in each dose may vary. Caregivers should also be cautious about keeping melatonin out of reach of children, as it is often sold in appealing forms like gummies or chewable tablets. Overall, while melatonin can be a valuable resource for some children, it should be used under the guidance of a physician and with proper safety precautions. [Extracted from the article]

Two linked studies have found that individuals with epilepsy have a higher risk of hospitalization and death from COVID-19 compared to those without the disorder. The risk of hospitalization for people with epilepsy was 60% higher, and the risk of death was 33% higher. However, during the pandemic, hospitalizations and emergency room visits for people with epilepsy decreased by as much as 30%. The findings suggest that the neurotropic effects of the virus or alterations in the immune system may contribute to the increased risk for people with epilepsy. The studies also found that healthcare utilization by people with epilepsy decreased during the pandemic, potentially due to the redeployment of healthcare professionals and canceled consultations. These findings may have implications for prioritizing COVID-19 treatments and vaccinations for people with epilepsy. [Extracted from the article]

According to a recent article in Internal Medicine News, levels of SARS-CoV-2 in wastewater have been declining over the past three weeks, suggesting that COVID-19 may be on the decline. However, other viruses that cause stomach and respiratory illnesses, such as flu, RSV, norovirus, and rotavirus, continue to circulate widely across the country. Positive flu test rates are climbing again, with 116 children and an estimated 20,000 adults having died from the flu this season. While RSV wastewater detection remains high, positive RSV test results reported to the CDC are at their lowest point of the season. Wastewater data provides a real-time view of pathogen behavior in the general population. COVID-19 metrics, including positive test rates, hospitalizations, and ER visits, are currently trending downward. However, it is important to remain cautious and continue following safety measures. [Extracted from the article]

The article examines the challenges faced by physicians to distinguish between, diagnose, and treat COVID-19 versus respiratory syncytial virus (RSV) and influenza. Topics include reason that COVID-19 patients to have trouble breathing, upper respiratory symptoms that patients with RSV and influenza tend to have, and factor that made it difficult to differentiate COVID-19 symptoms from those of RSV and influenza.

The article presents a study on the effectiveness of psychotherapy as drugs for depression in patients with heart failure (HF). Topics include the reduction in depressive symptom severity at six months for both behavioral activation (BA) and antidepressant medication management (MEDS) participants and improvement in physical health related quality of life (HRQOL) at six months among those who received BA.