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Suicidal behavior describes not only death caused by suicide but also intentional, nonfatal, self-injurious acts committed with or without the intent to cause death. Less severe suicidal attempts are particularly characteristic of persons with borderline personality disorder (BPD).

The recent report on an HIV-positive cardiothoracic surgeon in Israel has offered a contemporary perspective on the risks of transmission of HIV in health care settings, specifically surgical settings.

Employees are making changes to improve their health and better control their own health care costs in response to the current recession, according to results of a survey conducted for the National Business Group on Health (NBGH) by Fidelity Consulting Services.

The objective of this study was to estimate the annual cost burden of Parkinson disease (PD) in the United States. Resource use and cost profiles were developed using all-payer statewide hospital discharge data from 6 states; emergency department visit, long-term–care, and national survey data; fee schedules; and published study findings. (Average direct and indirect costs per patient were calculated in 2007 US dollars.) The annual cost per patient was $21,626 (direct cost: $12,491). When applied to the US PD population (N = 500,000), the annual average cost was approximately $10.78 billion (direct costs, $6.22 billion; indirect costs, $4.56 billion). PD has substantial economic consequences for patients and their families, insurers, and society. (Drug Benefit Trends. 2009;21:179-190)

The 2 physicians who now oversee the FDA want the agency to think of itself less as a regulator and more as a part of the nation’s public health apparatus.

Medication spend for workers’ compensation claims continues to increase despite decreases in overall occupational injury rates. Medication costs increased by 5.4% in 2008 following a 3.3% rise in 2007 (Cover Figure), according to findings of the 2009 Annual Drug Trends Report for Workers’ Compensation. The report was compiled and analyzed by PMSI, Tampa, Fla.

Recently, after getting her regular prescription for Synthroid filled at the pharmacy, my mother called the physician to complain that she just didn’t feel well. The doctor was considering increasing the dosage when my mother noticed that the pills looked different. She had been given a generic version. Her prescription was changed back to Synthroid and she felt fine again.

All elements of the skin are affected by age. In this 2-part article, I discuss how the blood vessels, the lymphatics, and the ground substance- which surrounds these vessels- respond to age, and I show how the aging elements of the vasculature can engender a variety of pathological cutaneous conditions.

Chronic obstructive pulmonary disease (COPD) is recognized as a common condition in older adults, but asthma is often considered something that most patients outgrow long before they retire and qualify for Medicare.

If patients cannot overcome the gag reflex when I try to depress their tongue with a tongue blade, I simply have them stand in front of a mirror and ask them to show me the back of their throat while I hold the light.

A quick way to determine rebound tenderness and differentiate between an acute and a nonacute abdomen in a child is to ask the patient to jump up and down. Patients with nonacute abdominal pain will do this willingly. However, those with an acute abdomen will typically decline because of pain.

A 76-year-old woman presents for evaluation of a long-standing sore just inside her lower lip. She has been referred by her dentist.

A 32-year-old woman complains of eye symptoms that began 3 to 6 months earlier. She first experienced increased lacrimation and a gritty feeling in the eyes.

Inhaled medications are the cornerstoneof therapy for most of themore than 30 million Americanswho have asthma or chronic obstructivepulmonary disease(COPD). Unfortunately, many ofthese patients use aerosol deliverydevices incorrectly.

All elements of the skin are affected by age. In this 2-part article, I will discuss how the blood vessels, the lymphatics, and the ground substance- which surrounds these vessels-respond to age, and I will show how the aging elements of the vasculature can engender a variety of pathological cutaneous conditions.

IBM is rewarding participation in its wellness programs for US employees and dependents with cash. In October, the company added a fourth cash rebate worth $150 to its healthy living programs, first introduced in 2004. The Children's Health Rebate is designed to address the significant increase in obesity rates among children. Other $150 cash wellness incentive programs focus on healthy eating and weight loss, exercise, and smoking cessation. Employees can choose any 2 rebates to receive $300 in cash per year.

Theoretically at least, every day in any hospital should be the same. That means that every patient should be treated with the same quality and safety standards whether it be Sunday or Wednesday. In reality, however, the evidence suggests that there is a “weekend effect,” which translates into worse outcomes for patients admitted to the hospital on weekends for serious illnesses.

Written in appreciation of “100 Precepts for My House Staff” by Henry Schneiderman, MD, and dedicated to those fierce internist attendings who have bred fear, insight, and wisdom in so many of us (Part 1 in CONSULTANT, April 2009, page 270, and Part 2 on page 361 of the June issue).