Myths and Realities

Myths and Realities: Is My Cirrhotic Patient Auto-anticoagulated?

January 12, 2017
Myths and Realities: Is My Cirrhotic Patient Auto-anticoagulated?

By B. Corbett Walsh, MD

Peer Reviewed

Case: A 65 year-old man with cirrhosis is admitted to the ICU for severe pneumonia. His hepatic dysfunction is chronically severe, as indicated by a MELD score of 31, and he has a stable thrombocytopenia of 110,000 platelets/ml. Should this patient be on DVT prophylaxis?

MYTH: Patients with severe hepatic dysfunction resulting in a significantly elevated INR are auto-anticoagulated and protected against venous thromboembolic events.

The liver is responsible for a plethora of processes: metabolic (carbohydrate and lipid …

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Myth or Reality: Are Shellfish Allergies Related to Contrast Reactions?

January 13, 2016
Myth or Reality: Are Shellfish Allergies Related to Contrast Reactions?

By Ian Fagan, MD

Peer Reviewed

I was recently vacationing on a cruise ship. As anybody who regularly cruises most certainly knows, you make your money back not in the casino, but rather on lobster night—a meal consisting of endless portions of delicious, succulent lobster tail.

A table mate of mine did not order the lobster. When asked why, she shared an interesting tale: After 40 years of eating shellfish as she pleased, she was found to be “allergic to iodine” and was subsequently warned …

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Myth vs. Reality: Can Deodorant Cause Breast Cancer?

November 6, 2014
Myth vs. Reality: Can Deodorant Cause Breast Cancer?

By Dana Zalkin

Peer reviewed

Recently, my own mother approached me with a personal medical question: “Is it true that I need to avoid antiperspirants given that I’m a breast cancer survivor?” From her tone, it was clear that she wanted a particular answer from me: “No, mom, that’s just a myth.” But in all honesty, I had no idea. Her surgeon had advised against antiperspirant use, but her radiologist denied any association between the product and breast cancer. So, in honor of my mother …

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From The Archives – The Hangover: Pathophysiology and Treatment of an Alcohol-Induced Hangover

January 16, 2014
From The Archives – The Hangover: Pathophysiology and Treatment of an Alcohol-Induced Hangover

Please enjoy this post from the archives, dated May 27, 2011

By Anthony Tolisano

Faculty Peer Reviewed

The sunlight forces its way into your eyes, stabbing at your cortex. Suddenly, a wave of nausea and diarrhea grips your stomach, threatening to evacuate its contents. You rush to the bathroom, tripping over the clothes that speckle your apartment. Your heart pounds inside your chest and your hands shake ever so subtly. Your mind is in a fog and the details of last night’s party are a …

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The DLO: Does FFP Correct INR?

September 20, 2013
The DLO: Does FFP Correct INR?

By Nicole A Lamparello, MD

Faculty Peer Reviewed

Page from the hematology laboratory: critical lab value; INR 1.9. Liver biopsy scheduled for tomorrow. What is a knowledgeable physician practicing evidence-based medicine to do?

Fresh frozen plasma (FFP) is the liquid, acellular component of blood. FFP contains water, electrolytes, and the majority of the coagulation proteins . It is frequently transfused to patients with an elevated prothrombin time (PT), a measure of the activity of the common coagulation pathway (involving factors X, V, prothrombin and fibrinogen) …

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Clinical Misinformation: The Case of Benadryl Causing Dementia

May 22, 2013
Clinical Misinformation: The Case of Benadryl Causing Dementia

By Natalie Smith, MD

Faculty Peer Reviewed

A few weeks ago I received an email from a friend I grew up with containing a link to an article she had seen online and a question as to its implications. The email was directed to me, the medical student, but was also sent to eight of our other closest friends. I clicked on the link and found a short article titled, “What drugs are known to cause memory loss?” My friend’s particular concern was based on …

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From The Archives – Myths and Realities: Heart and Wine

September 27, 2012
From The Archives – Myths and Realities: Heart and Wine

Please enjoy this post from the archives dated August 26, 2010

By Aditya Mattoo, MD

Faculty Peer Reviewed

Not too long ago, a patient came to my clinic and said (I’m paraphrasing of course), “I never cared for alcohol, doctor, so I haven’t had much to drink since my college days. Maybe champagne or wine on the rare special occasion, but I keep hearing about how wine is good for your heart, so I am thinking I should start drinking regularly.” For years I have …

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Does Stress Cause Stress Ulcers? The Etiology and Pathophysiology of Stress Ulcers

August 22, 2012
Does Stress Cause Stress Ulcers? The Etiology and Pathophysiology of Stress Ulcers

Sara-Megumi Naylor, MD

Faculty Peer Reviewed

When Warren and Marshall were awarded the Nobel Prize in Physiology or Medicine in 2005 for their work on Helicobacter pylori and peptic ulcer disease , a long-standing controversy concerning the major cause of peptic ulcers was settled. They are not due to the reasons—spicy food, excessive coffee consumption, poor sleep, a stressful lifestyle—that we have heard from relatives and perhaps believed over the years. It is now well accepted that the leading causes of peptic ulcers are infection …

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