Metformin-prescribing rates are low, particularly in patients receiving insulin, with Medicare insurance, seen by medical or surgical specialists, or with four or more chronic conditions. The observed low rates of metformin use represent an important opportunity to improve the quality of care for patients with type 2 diabetes.

Objective. To identify the methods used by US colleges and schools of pharmacy to prepare student pharmacists for academic careers.Method. An 18-item survey instrument was developed and distributed to US colleges and schools of pharmacy. Representatives were asked about faculty responsibilities, experiences in academia currently offered to student pharmacists, and representatives' perception of their student pharmacists' preparedness for careers in academia, including barriers in current programming. Results. Representatives from 96 colleges/schools responded. The vast majority (96%) provided academia-focused advanced pharmacy practice experiences (APPEs), 40% provided didactic coursework in academia, 28% offered a longitudinal research track, and 42% offered academia-focused independent studies. Teaching methods and creating learning objectives were the most common pedagogical content, while assessment activities were diverse. Time was the most prevalent barrier to providing training for academic careers; however, degree of student pharmacist interest, faculty inexperience, and lack of leadership support were also commonly reported. Conclusions: Colleges and schools of pharmacy vary in the extent to which they prepare student pharmacists for careers in academia. Advanced pharmacy practice experiences were the most common method of training offered. Standardization of training for academia may better promote this career path to student pharmacists.

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Tranexamic acid demonstrated a significant benefit in decreasing change in hemoglobin as well as the need for blood transfusion with no increase in the risk of venous thromboembolism in patients undergoing total knee or total hip replacement.

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Background: In hospitalized patients, hyperglycemia is defined as blood glucose greater than 140 mg/dL. Hyperglycemia can lead to the development of nosocomial infections as well as cardiovascular events.  Despite these risks, current guidelines recommend blood glucose be maintained between 140-180 mg/dL. Previous studies have shown that elevated blood glucose levels are associated with increased patient mortality. However, these studies assessed blood glucose at a single point in time. Objective: The primary objective of this study is to determine the impact of average blood glucose >140 mg/dL on a composite outcome of intensive care unit transfer, death, length of stay > 4 days, development of nosocomial infection, or new cardiovascular event (myocardial infarction [MI], ischemic stroke, deep vein thrombosis [DVT], pulmonary embolism [PE], or new onset heart failure) occurring during patient admission. Methods: This single centered, randomized, case-control, retrospective chart review sorted adult medical/surgical patients into two groups, average blood glucose ≤140 mg/dL or >140 mg/dL, of 120 patients each. Results: Forty-seven (39.2%) patients in the >140 mg/dL group experienced the primary composite outcome versus 27 (22.5%) patients in the ≤140 mg/dL group (p=0.005). Secondary outcomes found that patients with diabetes in the >140 mg/dL group were more likely to experience the primary outcome than those in the ≤140 mg/dL group (41 (48.8%) vs 3 (13.6%) p=0.003). Conclusions: This study found that medical/surgical patients with an average blood glucose >140 mg/dL may be at an increased risk of developing adverse patient outcomes.