The Forbidden Fruit

January 27, 2017
The Forbidden Fruit

By Varun Narendra

Peer Reviewed

Griffith Hughes was the first to describe the grapefruit in 1750, naming it the “forbidden fruit” of Barbados for unknown reasons. Centuries later, it seems as if he may have been on to something, as grapefruit juice (GFJ) has been shown potentially to interact dangerously with a list of commonly prescribed medications. This list has steadily grown to include over 85 drugs.1 Meanwhile, the Internet is rife with anecdotes of near-death experiences attributed to drug interactions with the much-maligned fruit. …

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From The Archives – In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

January 26, 2017
From The Archives – In Search of a Competitive Advantage: A Primer for the Clinician Treating the Anabolic Steroid User

Please enjoy this post from the archives dated, April 17, 2013

By David G. Rosenthal and Robert Gianotti, MD

Faculty Peer Reviewed

Case: A 33-year-old man comes to your clinic complaining of worsening acne over the last 6 months. You note a significant increase in both BMI and bicep circumference. After several minutes of denial, he reveals that he has been using both injectable and oral anabolic steroids. He receives these drugs from a local supplier and via the Internet. He confides that his libido …

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Optimism

January 25, 2017
Optimism

By Adam Blaisdell, MD

Peer Reviewed

Present Day – The patient is a 61 year-old male who presents with a one-week history of jaundice and intense pruritus. He has a medical history significant for hepatitis C virus (HCV) infection (genotype 1a) diagnosed 15 years ago, which was never treated. Three years prior, the patient was also diagnosed with hepatocellular carcinoma (HCC) and underwent transcatheter arterial chemoembolization (TACE) but was subsequently lost to follow-up. He has no documented evidence of cirrhosis. On this admission his total …

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Primecuts – This Week In The Journals

January 24, 2017
Primecuts – This Week In The Journals

Lee,Chang W. – from camera serial number NYTCREDIT: Chang W. Lee/The New York Times

By Calvin Ngai, MD

Peer Reviewed

In former President Barack Obama’s last farewell speech, he asked all fellow Americans to continue to believe in our ability to create change. This past weekend, the day after Donald J. Trump was sworn into the presidential office and our country bid one last farewell to former President Obama, hundreds of thousands of women gathered in Washington D.C. (millions, including marches from all around the …

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Gamechanger? Can Pioglitazone Reduce Cardiovascular Events After a Stroke? An Analysis of the IRIS Trial

January 19, 2017
Gamechanger?  Can Pioglitazone Reduce Cardiovascular Events After a Stroke?  An Analysis of the IRIS Trial

By Johanna Hase, MD

Peer Reviewed

Welcome to Gamechangers, a series that takes a critical look at the latest in medical literature to answer one important question: would the results of this article change my practice? Featuring thorough evidence-based review as well as expert commentary, our aim is for this series to help you decide if the results of a given study are, in fact, a gamechanger

A 64 year old woman with pre-diabetes, hyperlipidemia, and hypertension on aspirin, losartan and simvastatin, recently was diagnosed …

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Primecuts – This Week In The Journals

January 17, 2017
Primecuts – This Week In The Journals

By Scott Butler, MD 

Peer Reviewed

A presidential goodbye. A contentious press conference.  A salacious dossier from a British spy.  It’s been quite a week.

As Republican legislators transition from symbolically voting to repeal Obamacare (over 50 times since its inception) to making its dissolution a reality, it becomes increasingly clear that “replace” is the much more challenging half of the promise to “repeal and replace” the law. Theodore Roosevelt backed a plan for universal coverage when he sought an elusive third term in 1912.  …

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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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Primecuts – This Week In The Journals

January 9, 2017
Primecuts – This Week In The Journals

By: Nancyanne Schmidt, MD

Peer Reviewed

This week, the intelligence report commissioned by President Obama on suspected hacking during the recent presidential election revealed that Russian President Vladimir Putin ordered an influence campaign aimed at undermining The Democratic National Committee and Hillary Clinton’s campaign, in particular. The report, which compiled the collective assessments of the C.I.A., National Security Agency and F.B.I., stopped short of implicating Russia in the outcome of the recent presidential election in which President-elect Donald Trump defeated Hillary Clinton in a …

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