Primecuts – This Week In The Journals

February 24, 2014
Primecuts – This Week In The Journals

By Miguel A. Saldivar, MD

Peer Reviewed

This week’s edition of Primecuts brings highlights from studies on a variety of topics ranging from prescription drug abuse to cost-effective medical care. Given that the CDC classified the issue of prescription drug abuse/overdose as an “epidemic” in 2012, we begin with a paper on opiate prescriptions in the Medicare population.

The relationship between use of multiple opiate providers and hospitalizations

The British Medical Journal published a retrospective observational study that analyzed data on opiate prescriptions…

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An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

February 21, 2014
An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

By Gabriel Schneider, MD

Peer Reviewed

The new oral anticoagulants (NOACs) are an appealing alternative to the burdensome vitamin K antagonists such as warfarin. These novel agents include direct thrombin inhibitors such as dabigatran (which inhibits thrombin) and factor Xa inhibitors such as rivaroxaban and apixaban (which prevent thrombin generation). Compared to warfarin, NOACs have fewer food and drug interactions, as well as a more predictable pharmacodynamic profile that serves to obviate the need for the frequent outpatient monitoring in most patients. In addition…

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What Physicians Should Know About MDMA (Ecstasy)

February 20, 2014
What Physicians Should Know About MDMA (Ecstasy)

By Loren Gorcey

Peer Reviewed

With the recent resurgence of techno music and raves in the United States, the drug MDMA, known worldwide by the name “ecstasy,” has experienced a comeback. In light of a New Year’s Eve rave in Los Angeles in 2010, where 18 MDMA-related emergency room visits and 1 death occurred, MDMA is once again becoming a problem . Locally, 4 MDMA-related emergency room visits and 2 MDMA-related deaths occurred this past summer at Electric Zoo, an annual electronic music festival in…

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Primecuts – This Week In The Journals

February 18, 2014
Primecuts – This Week In The Journals

By Miguel A. Saldivar, MD

Peer Reviewed

While walking through snowy streets of NYC, the sight of one or two innocent bystanders sliding on a patch of ice on the road is not uncommon. However, these unfortunate folks are far from being the only ones with a bruise or two: this week a widely accepted screening tool, the mammogram, received more than a few punches in the media.

The Cost of Mammography

The utility of mammography as a screening tool, questioned in a Canadian study…

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Mammograms in the News, Yet Again

February 13, 2014
Mammograms in the News, Yet Again

By Miguel A. Saldivar, MD

Peer Reviewed

Mammograms are far from strangers to the paparazzi. It was only recently that a television news reporter from a prominent broadcasting company reluctantly agreed to have a mammogram performed on live television to promote breast cancer screening and help “save lives” . That same study diagnosed her with breast cancer, which was followed by the impressive statement from her physicians: “that mammogram just saved your life”. But over the last day or two several major newspapers are presenting…

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Primecuts – This Week In The Journals

February 10, 2014
Primecuts – This Week In The Journals

By Luke O’Donnell, MD

Peer Reviewed

I guess being single in New York should make me dread Valentine’s Day. But I don’t. Maybe it is my years of studying a language that has words to distinguish love in all its manifestations: the once-in-a-lifetime stuff (amour) versus the form with the same amount of intimacy but less commitment (amant). Anyway, enjoy the first article; it is about an emerging communicable disease. Kisses everyone.

If the ever-looming scare of H5N1 was not enough, the New England Journal…

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From The Archives: Low Dose Vitamin K Supplementation and Anticoagulation Control

February 6, 2014
From The Archives: Low Dose Vitamin K Supplementation and Anticoagulation Control

Please enjoy this post from the archives dated July 21, 2011

By Joanna Becker

Faculty Peer Reviewed

Patients who are placed on long-term warfarin (Coumadin) therapy are sent home with a lengthy list of restrictions to minimize variations in warfarin efficacy. The agents that can alter warfarin levels can be divided into 2 categories: (1) those that interact with cytochrome P450, which metabolizes warfarin and (2) those that alter phytonadione (vitamin K) levels.  The majority of inter- and intra-individual warfarin dose variability is attributable to…

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Should Beta-Blockers Be Used In The Setting Of Cocaine-Related Chest Pain?

February 5, 2014
Should Beta-Blockers Be Used In The Setting Of Cocaine-Related Chest Pain?

By Matthew A. Haber

Peer Reviewed

The following is a hypothetical example of a classic exam question that one might come across as a medical student:

A 50-year-old male presents to the emergency department with severe chest pain. His past medical history is significant for congestive heart failure and stent placement. His vitals are significant for a blood pressure of 220/110 and a heart rate of 170. On physical exam he appears to be profusely sweating, and his pupils are markedly dilated. Troponin I is…

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