管家婆心水论坛

September 2016

Medical  Student Perspective:  Always More to the Story
I knew that at some point a patient would get to me. It happened sooner than I thought and came as a surprise when it did. She was an elderly patient who had been hospitalized for months due to a series of complications and infections. She couldn't speak well enough to be understood because she had a trach, and she was weak and frail. She was deemed mentally incompetent and was not listed as DNR, but when she whispered to me to just let her die, her eyes were clear.

My Kind of Medicine: Real Lives of Practicing Internists
Growing up as the 鈥渢ypical middle child,鈥 family life has always been important to Lawrence Phillips, MD, FACC, FACP, FASNC. Now, as a medical director and clinician educator at NYU Langone Medical Center, he鈥檚 eager to embrace internal medicine as the biggest family he鈥檚 ever had.

Winning Abstracts: Pregnancy in Simultaneous Pancreas-Kidney (SPK) Transplant: Is it worth the risk?
While numerous successful pregnancies in recipients of solid organ transplants have been reported, definitive data on maternal, fetal and graft outcomes is still lacking. We report an interesting case of renal allograft rejection that occurred in a simultaneous pancreas and kidney (SPK) transplant recipient during pregnancy.

The Prevalence of Resident-to-Resident Elder Mistreatment in Nursing Homes
Mistreatment of nursing home residents by staff is a well-known phenomenon, and policies and initiatives have been developed to detect, prevent, and prosecute such abuse. In an observational study, mistreatment committed by other residents, including threats and physical, verbal, and sexual actions, was determined and compared with that committed by staff.

Subspecialty Careers: Critical Care Medicine
Critical care medicine encompasses the diagnosis and treatment of a wide variety of clinical problems representing the extreme of human disease. Critically ill patients require intensive care by a coordinated team. The critical care specialist (sometimes referred to as an 鈥渋ntensivist鈥) may be the primary provider of care or a consultant.


Acute gastrointestinal (GI) bleeding is common in both the outpatient setting and the emergency department. Annual U.S. incidence rates over the past decade are approximately 90鈥108 per 100 000 persons (), leading to approximately 300 000 hospitalizations annually. Most cases are due to nonvariceal sources of bleeding (e.g., peptic ulcers) and continue to be associated with significant mortality (3鈥14%) and health economic burden (鈥).

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