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Most clinicians maintain a fairly glucose-centric view of diabetes. That is, we have made the assumption that the most visible derangement in diabetes, hyperglycemia, is the culprit producing vascular disease.
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Lack of sleep impairs the immune system and lowers resistance to viral illness. The quality of sleep is important. Those volunteers who spent less than 92% of their time in bed asleep were five-and-a-half times more likely to become ill than those who were asleep for at least 98% of their time in bed.
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In a multicenter, prospective, randomized study of Japanese Type 2 diabetic patients, low-dose aspirin as primary prevention did not reduce the risk of cardiovascular events.
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Erythromycin, 250 mg bid, reduced the number of exacerbations in patients with moderate COPD over a 1-year period.
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The ECG shown above was obtained from a patient with acute shortness of breath. The QRS complex was recognized to be wide, and the clinical question raised was whether the patient should be immediately shocked. How would you respond?
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This single-center, randomized controlled trial demonstrated that intensive insulin therapy targeting blood glucose values of 80-110 mg/dL does not improve mortality, but does increase the incidence of hypoglycemia in a group of critically ill medical and surgical patients.
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Through a retrospective analysis, this study examined ICU resource use and costs for 121,747,260 inpatient hospitalizations, and found a rapid rise in Medicare ICU use with stable adjusted daily critical care costs, but increasing costs for care outside the ICU.
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A quality improvement intervention aimed at improving palliative care in the ICU resulted in improvements of nurse-assessed quality of dying and a reduction in ICU length of stay, but no changes in family perceptions of quality of dying or satisfaction with care.