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MKSAP Quiz: difficult-to-treat migraine

A 30-year-old woman is evaluated for difficult-to-treat migraine. She has had severe headaches, usually on the first day of menses, since menarche. The pain is hemicranial, pulsatile, and associated with severe nausea and vomiting but no aura. She frequently awakens with the attack already in progress. A series of drug regimens have become ineffective in controlling pain. Following physical and neurological exams, what is the most appropriate next step in treatment?
https://immattersacp.org/weekly/archives/2016/09/20/3.htm
20 Sep 2016

Navigating the improvement activity component of MIPS

The Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is not as intimidating as it sounds—at least for 2017, which is a transition year that will determine what internists are paid in 2019.
https://immattersacp.org/archives/2017/02/tips.htm
1 Feb 2017

Internal Medicine Meeting 2017 offers new, rapid-fire session

At Internal Medicine Meeting 2017, expect to hear recent research findings, clinical pearls and pitfalls, and maybe the sound of a gong.
https://immattersacp.org/archives/2017/02/preview.htm
1 Feb 2017

Lack of coordination between health care systems associated with fatal opioid overdoses

Veterans who received opioid prescriptions from both inside and outside the Veterans Affairs health system had two to three times the risk for fatal overdose versus those who received prescriptions from only one source.
https://immattersacp.org/weekly/archives/2019/03/12/1.htm
12 Mar 2019

Model finds universal HIV PrEP not cost-effective for injection drug users

Money instead spent on issues related to injection drug use, such as naloxone therapy and detoxification programs, would not only prevent HIV infections but also save lives, an editorial noted.
https://immattersacp.org/weekly/archives/2016/04/26/1.htm
26 Apr 2016

Palliative care's place outside cancer

Integrated palliative care is important in offering comfort measures to patients with conditions that are expected to shorten their life spans.
https://immattersacp.org/archives/2019/06/palliative-cares-place-outside-cancer.htm
1 Jun 2019

Evidence lacking on efficacy of prescription drug monitoring programs

Features of prescription drug monitoring programs associated with reductions in overdoses included mandatory review of data by clinicians before writing prescriptions, frequent (at least weekly) updates of data, clinician authorization to access data, and monitoring of nonscheduled drugs.
https://immattersacp.org/weekly/archives/2018/05/08/1.htm
8 May 2018

Dabigatran recalled, dense-breast notification required

This column reviews recent recalls, alerts, and approvals.
https://immattersacp.org/archives/2023/05/dabigatran-recalled-dense-breast-notification-required.htm
1 May 2023

Increasing rates of chronic pain found among those who die by suicide

Among suicide decedents included in the study, 8.8% had evidence of chronic pain, and the percentage increased from 7.4% in 2003 to 10.2% in 2014.
https://immattersacp.org/weekly/archives/2018/09/11/1.htm
11 Sep 2018

Prevent, recognize impairment

Professional duties require physicians to recognize and address physician illness and impairment, but it is often difficult to recognize a colleague's condition and find an appropriate way of reporting and resolving it.
https://immattersacp.org/archives/2019/09/prevent-recognize-impairment.htm
1 Sep 2019

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