The Exchange

Commentary and Observations from
the Medical Front Lines

Ben Taylor, PA-C, PhD, DFAAPA

Ben Taylor, PA-C, PhD, DFAAPA

  • Clinical Faculty
  • Augusta University
  • Augusta, Georgia
  • Adjunct Faculty
  • Rocky Mountain University
  • Provo, Utah
Screening for Unhealthy Drug Use

Screening for Unhealthy Drug Use

Despite all the knowledge and technology that we have these days, we still see a vast amount of patients who engage in unhealthy substance use (eg, alcohol, illicit drugs, tobacco) and think that there will be no health consequences. Even if the patient frequently presents to primary care, unhealthy alcohol and other drug use often goes unrecognized. Approaches to alleviate substance use problems include screening, brief interventions, and when appropriate, referral to an addiction treatment... Continue Reading

Filed under: Public Health, Substance Abuse

Alcoholic Cardiomyopathy

Alcoholic Cardiomyopathy

I had a patient the other day who came in intoxicated and tried to "school" me on the benefits of alcohol. Yes, there are some potential heart-healthy benefi... Continue Reading

Filed under: Cardiometabolic, Substance Abuse

Hyponatremia and Alcoholism

Hyponatremia and Alcoholism

"Beer potomania" is a syndrome used to describe patients who present with hyponatremia along with a history of excessive beer drink... Continue Reading

Filed under: Neurology, Substance Abuse

Acute Versus Chronic Mesenteric Ischemia

Acute Versus Chronic Mesenteric Ischemia

Acute mesenteric ischemia (AMI), also commonly called bowel or intestinal ischemia, refers to inadequate blood flow to the small intestine (arterial or venou... Continue Reading

Filed under: Gastroenterology, Miscellaneous

Throat Abscess Differentiation

Throat Abscess Differentiation

Deep neck space infections are frequently seen in medical clinics and EDs despite the advent of antibiotics. They most commonly arise from a septic focus of... Continue Reading

Filed under: Miscellaneous

Single HCV Screening for All Adults

Single HCV Screening for All Adults

Hepatitis C virus (HCV) is a contagious hepatic disease that lives in blood and bodily fluids, and can be passed from person to person through infected blood... Continue Reading

Filed under: Infectious Diseases, Preventive Medicine

Better Sleep Linked to Reduced Cardiovascular Disease and Stroke Risk

Better Sleep Linked to Reduced Cardiovascular Disease and Stroke Risk

We all know that sleep is crucial for heart health. Research has shown that regardless of a person's age, weight, smoking habits, and exercise l... Continue Reading

Filed under: Cardiometabolic, Preventive Medicine, Pulmonary Medicine

Should We Accommodate Discriminatory Requests from Patients?

Should We Accommodate Discriminatory Requests from Patients?

As medical providers, we took an oath to provide the same quality of care to all our patients regardless of their race, gender, religion, sexual orientation,... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

Heart Disease and Cancer Risk

Heart Disease and Cancer Risk

According to data to be presented this month at the American Heart Association's (AHA) 2019 Scientific Sessions, heart attack survivors may hav... Continue Reading

Filed under: Cardiometabolic

Measles and Immunity

Measles and Immunity

Measles is a highly contagious viral illness, currently targeted for eradication given the favorable biologic characteristic that humans are the only reservo... Continue Reading

Filed under: Allergy/Immunology, Infectious Diseases

Prescription Drug Misuse in the United States

Prescription Drug Misuse in the United States

Narcotic prescription medications have important medical uses, but they also stimulate the reward center of the brain. In susceptible individuals, this can l... Continue Reading

Filed under: Health Policy and Trends, Substance Abuse

Management of Patients with Suspected EVALI

Management of Patients with Suspected EVALI

Over the last several years there has been a dramatic spike in individuals vaping, and we have witnessed the associated injuries—including bur... Continue Reading

Filed under: Health Policy and Trends, Pulmonary Medicine

Left Main Coronary Artery Occlusion: ST Elevation in aVR

Left Main Coronary Artery Occlusion: ST Elevation in aVR

During my ECG training, we were taught that the findings from lead aVR were only important for supportive evidence of pericarditis. I subsequently learned di... Continue Reading

Filed under: Cardiometabolic

The “HINTS” Examination in Vertigo

The “HINTS” Examination in Vertigo

Vertigo is a symptom, not a diagnosis. It presents a unique problem for many clinicians because it is symptomatic of a plethora of diagnoses, ranging from be... Continue Reading

Filed under: Miscellaneous, Neurology

Thoracic Aortic Aneurysm (Part 2)

Thoracic Aortic Aneurysm (Part 2)

Thoracic aortic aneurysms (TAA) often expand slowly over time and usually without symptoms, making them difficult to detect. Some aneurysms never rupture. Ma... Continue Reading

Filed under: Cardiometabolic

Thoracic Aortic Aneurysm (Part 1)

Thoracic Aortic Aneurysm (Part 1)

Thoracic aortic aneurysms (TAA) are located above the diaphragm, may involve one or more aortic segments (aortic root, ascending aorta, arch, or descending a... Continue Reading

Filed under: Cardiometabolic

Energy Drinks Tied to QTc Prolongation

Energy Drinks Tied to QTc Prolongation

Consuming caffeinated energy drinks is associated with QTc interval prolongation, which is a risk factor for torsades de pointes, according to a small study... Continue Reading

Filed under: Cardiometabolic

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

The American Geriatrics Society (AGS) 2019 Updated Beers Criteria—updated from 2015—are designed to reduce older adults' drug-related problems including,... Continue Reading

Filed under: Health Policy and Trends, Preventive Medicine

Acute Renal Failure After Cancer Treatment

Acute Renal Failure After Cancer Treatment

Acute renal failure (ARF) in cancer patients is a dreadful complication that causes substantial morbidity and mortality. ARF is defined as a sustained and ab... Continue Reading

Filed under: Oncology/Hematology, Urology

The Mediterranean Diet and Cardiovascular Disease

The Mediterranean Diet and Cardiovascular Disease

The Mediterranean diet represents the most notable overall dietary pattern in nutritional epidemiology that has been extensively studied over the last 2 deca... Continue Reading

Filed under: Public Health

Advanced Practice Providers and Liability Risk

Advanced Practice Providers and Liability Risk

It is a misconception that advanced practice providers (APPs) can’t get sued because any errors are a physician’s responsibility. PAs and NPs can and do... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

Procalcitonin Levels in the Management of COPD Exacerbations

Procalcitonin Levels in the Management of COPD Exacerbations

The use of procalcitonin-based protocols to guide the decision to administer antibiotics has been evaluated in infections of different origins and settings.... Continue Reading

Filed under: Infectious Diseases, Pulmonary Medicine

Hypertension in the Pediatric Population

Hypertension in the Pediatric Population

The prevalence of systemic hypertension (HTN) in the pediatric population is now commonly observed to be increasing, especially in view of the growing popula... Continue Reading

Filed under: Cardiometabolic, Health Policy and Trends, Preventive Medicine

Fluoroquinolone Use and the Potential Risk for Aortic Aneurysm or Dissection

Fluoroquinolone Use and the Potential Risk for Aortic Aneurysm or Dissection

Fluoroquinolones have long been a popular class of antibiotics for use in a myriad of infections. There are even newer fluoroquinolones that have been develo... Continue Reading

Filed under: Cardiometabolic, Infectious Diseases

Aspirin Use for ASCVD Prevention

Aspirin Use for ASCVD Prevention

For decades aspirin has been a staple of primary prevention of atherosclerotic cardiovascular disease (ASCVD) in at-risk populations, based on recommendation... Continue Reading

Filed under: Cardiometabolic, Preventive Medicine

Treating the Hypertensive Patient With Chronic Kidney Disease

Treating the Hypertensive Patient With Chronic Kidney Disease

Hypertension (HTN) is present in approximately 80% to 85% of patients with chronic kidney disease (CKD). Uncontrolled HTN is the second leading cause of kidn... Continue Reading

Filed under: Urology

Anticoagulants and Recurrent Thrombosis

Anticoagulants and Recurrent Thrombosis

The other day a student asked me, "If a patient is taking a blood thinner for a previous venous thromboembolism (VTE), is it still possible for them to get a... Continue Reading

Filed under: Pulmonary Medicine

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