A Rocky Discontinuation of Diet Mountain Dew.

A 62-year-old man with a past medical history of recently diagnosed type II diabetes mellitus presented for multiple episodes of nephrolithiasis after stopping Diet Mountain Dew ingestion. Stone analysis confirmed calcium oxalate stones. It was theorized that the high citrate in Diet Mountain Dew was protective against his newly recurrent nephrolithiasis.

Elsberg Syndrome, Lumbosacral Radiculopathy, and Myelitis Due to Herpes Zoster in a Patient With Smoldering Myeloma.

Herpes zoster (HZ) is a common illness caused by the reactivation of latent varicella zoster virus (VZV) due to waning immunity, often secondary to old age or an underlying immunocompromised state. Its complications can manifest in variety of ways, including persistent neuralgias, vasculopathies, and stroke. Here, we describe a case of a 45-year-old man with a history of cryptogenic stroke and smoldering myeloma who was admitted with sacral HZ complicated by right lumbosacral radiculopathy and myelitis, otherwise known as Elsberg syndrome (ES).

Patient Demographics and Clinic Type Are Associated With Patient Engagement Within a Remote Monitoring Program.

Remote physiological monitoring (RPM) is accessible, convenient, relatively inexpensive, and can improve clinical outcomes. Yet, it is unclear in which clinical setting or target population RPM is maximally effective. To determine whether patients' demographic characteristics or clinical settings are associated with data transmission and engagement.

Remote patient monitoring sustains reductions of hemoglobin A1c in underserved patients to 12 months.

Aims: We sought to determine whether underserved patients enrolled in a statewide remote patient monitoring (RPM) program for diabetes achieve sustained improvements in hemoglobin A at 6 and 12 months and whether those improvements are affected by demographic and clinical variables.

Methods: Demographic and clinical variables were obtained at baseline, 6 months and 12 months. Baseline HbA1c values were compared with those obtained at 6 and 12 months via paired t-tests.

Effect of Payor-Mandated Review of Prescription Drug Monitoring Program on Opioid Prescriber Rates.

Objective: To evaluate the effect of a 2016 South Carolina payor mandate to query the state prescription drug monitoring program (PDMP) before prescribing controlled substances on the rate of opioid prescribers in South Carolina.

Methods: South Carolina PDMP datasets from 2010-2017 were evaluated using interrupted time series regression to compare changes in the rate of opioid prescribers before and after the 2016 mandate. The rate of opioid prescribers was defined as the number of prescribers who prescribed class II to IV opioids on any one prescription in each quarter divided by the total number of South Carolina prescribers who prescribed any one class II to IV medication.

Estimating the Economic Burden of Acute Myocardial Infarction in the US: 12 Year National Data.

Background: Acute myocardial infarction (AMI) carries a substantial mortality and morbidity burden. The purpose of this study is to provide annual mean cost per patient and national level estimates of direct and indirect costs (lost productivity from morbidity and premature mortality) associated with AMI.

Methods: Nationally representative data spanning 12 years (2003-2014) with a sample of 324,869 patients with AMI from the Medical Expenditure Panel Survey (MEPS) were analyzed.

Impact of Patient-Level Characteristics on In-hospital Mortality After Interhospital Transfer to Medicine Services: an Observational Study.

Background: National administrative datasets have demonstrated increased risk-adjusted mortality among patients undergoing interhospital transfer (IHT) compared to patients admitted through the emergency department (ED).

Objective: To investigate the impact of patient-level data not available in larger administrative datasets on the association between IHT status and in-hospital mortality.

Design: Retrospective cohort study with logistic regression analyses to examine the association between IHT status and in-hospital mortality, controlling for covariates that were potential confounders.

When Do Clinicians Follow-up Abnormal Liver Tests in Primary Care?

Background: Many guidelines addressing the approach to abnormal liver chemistries, including bilirubin, transaminases and alkaline phosphatase, recommend repeating the tests. However, when clinicians repeat testing is unknown.

Material And Methods: This retrospective study followed adult patients with abnormal liver chemistries in a patient-centered medical home (PCMH) from 2007 to 2016.

Patient perception of obesity versus physician documentation of obesity: A quality improvement study.

As the prevalence of obesity increases, the prevalence of associated comorbid diseases, obesity-related mortality rates and healthcare costs rise concordantly. Two main factors that hinder efforts to treat obesity include a lack of recognition by patients and documentation by physicians. This study evaluates the relationship between patient perception of obese weight and physician documentation of obesity.

Trends in Healthcare Expenditures Among US Adults With Hypertension: National Estimates, 2003-2014.

Background: One in 3 US adults has high blood pressure, or hypertension. As prior projections suggest hypertension is the costliest of all cardiovascular diseases, it is important to define the current state of healthcare expenditures related to hypertension.

Methods And Results: We used a nationally representative database, the Medical Expenditure Panel Survey, to calculate the estimated annual healthcare expenditure for patients with hypertension and to measure trends in expenditure longitudinally over a 12-year period.

Assessing the Burden of Abnormal LFTs and the Role of the Electronic Health Record: A Retrospective Study.

Background: Primary care clinicians encounter abnormal liver function tests (LFTs) frequently. This study assesses the prevalence of abnormal LFTs and patient follow-up patterns in response.

Methods: This is a retrospective study from 2007-2016 of adult patients with abnormal LFTs seen in an internal medicine clinic.

Identification of High Utilization Inpatients on Internal Medicine Services.

Background: As healthcare reform moves toward value based care, hospitals must reduce costs. As a first step, here we developed a predictive model to identify high-cost patients on admission.

Methods: We performed a retrospective observational study of 7,571 adults admitted to internal medicine services from July 1, 2013 to June 30, 2014.