Journal of general internal medicine
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Patients' views on the relative importance of treatment outcomes and medication attributes for type 2 diabetes may differ from clinicians' perceptions. ⋯ Patients and clinicians differ in the perception of the relative importance of treatment outcomes and drug characteristics. Individual patient preferences should be explored and implemented in the therapeutic decision-making for type 2 diabetes.
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Review Case Reports
Recurrent Sinopulmonary Infections in a Patient Whose HIV Masked Common Variable Immunodeficiency.
It is generally accepted that persons infected with human immunodeficiency virus (HIV) are at an increased risk of infection due to direct destruction of CD4+ lymphocytes and subsequently impaired cell-mediated immunity. Typically, HIV infection is associated with immunoglobulin elevations, but quantitative deficiencies in immunoglobulins have also been rarely described. ⋯ We review epidemiology, clinical presentation, and treatment of primary immunoglobulin deficiency. We also review the relationship between immunoglobulin deficiency and HIV and highlight the importance of recognizing the coexistence of two distinct immunodeficiency syndromes.
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Racially or ethnically targeted events may have adverse health implications for members of the group not directly targeted, a phenomenon known as peripheral trauma. Recent evidence suggests that mass incarceration, police brutality, and immigration actions all have such effects, as did medical exploitation by the US government during the Tuskegee Study of Untreated Syphilis in the Negro Male. ⋯ Practitioner awareness of peripheral trauma is an important element of cultural competency. But among options to substantially improve minority trust in the healthcare system, the diversification of medical practitioners may hold greatest promise.
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Hyponatremia is the most common electrolyte disturbance amongst hospitalized patients. An overly rapid rate of correction of chronic hyponatremia is believed to increase the risk of poor clinical outcomes including osmotic demyelination syndrome (ODS). There is disagreement in the literature regarding the definition of hyponatremic overcorrection. ⋯ Published methods disagree regarding the calculation of sodium correction rates and the definition of hyponatremic overcorrection. This leads to wide variations in sodium correction rates and the prevalence of overcorrection in patient cohorts. Definitions based on ODS risk are needed.