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Caught on Colonoscopy: Schistosomiasis Manifesting as a Single Colonic Polyp

A screening colonoscopy identified an unexpected diagnosis in a 64-year-old male patient. He was an asymptomatic landscaper who presented for a first-time screening colonoscopy based on age. His only active medical issue was psoriasis, for which he took apremilast. At the time of colonoscopy, he denied any bright red blood per rectum, melena, changes in […]

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Coaching Patients Saves Lives and Money (video)

The Coaching On Achieving Cardiovascular Health (COACH) Program has been proven to improve biomedical and lifestyle cardiovascular disease (CVD) risk factors. The objective of this study was to evaluate the long-term impact of The COACH Program on overall survival, hospital utilization, and costs from the perspective of a private health insurer (payor), in patients with […]

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Cloudy, amber, ascitic fluid had a triglyceride level of 375 mg/dL. A level >200 mg/dL is consistent with chylous ascites.1

When Appearance Is Everything: Chylous Ascites

The patient had numerous bouts of ascites, but this time the fluid’s color and composition heralded a new and ominous diagnosis. A 75-year-old woman with cirrhosis secondary to nonalcoholic steatohepatitis was admitted with abdominal pain. Her medical history also included coronary artery bypass grafting, congestive heart failure with a reduced ejection fraction of 40%, chronic […]

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Nurse Practitioners & Physicians as Effective as Physicians in Early Diabetes Care (video)

Who should care for patients in the first five years of a diabetes diagnosis? New research in the American Journal of Medicine reveals that nurse practitioners, physician assistants and doctors are comparable in their management of diabetes during the first five years. You can read “Nurse Practitioners, Physician Assistants, and “Physicians Are Comparable in Managing […]

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Trends in 30-Day Readmission Rates for Medicare and Non-Medicare Patients in the Era of the Affordable Care Act

Temporal changes in the readmission rates for patient groups and conditions that were not directly under the purview of the Hospital Readmissions Reduction Program (HRRP) can help assess whether efforts to lower readmissions extended beyond targeted patients and conditions. Methods Using the Nationwide Readmissions Database (2010-2015), we assessed trends in all-cause readmission rates for 1 […]

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Intra-Abdominal Varix Rupture: A Life-Threatening Cause of Hemoperitoneum

A 54-year-old male with decompensated alcoholic cirrhosis presented after a syncopal event and ground-level fall. Initial examination noted a distended abdomen without overlying bruising. At admission, his hemoglobin was 6.3 g/dL from a baseline of 8-10 g/dL. A computed tomography scan of the abdomen was notable for “complex ascites” adjacent to his liver concerning for […]

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